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Cancer diagnosis disclosure from Portuguese physicians

Published online by Cambridge University Press:  27 August 2014

Lucília Oliveira ,
Marta Fernandes ,
Zulmira Santos ,
Hugo Bastos  and
Ana Cabral
Lucília Oliveira*
Affiliation:
Department of Psychiatry, Psycho-Oncology Unit, Coimbra University Hospital Centre, Coimbra, Portugal
Marta Fernandes
Affiliation:
Department of Psychiatry, Psycho-Oncology Unit, Coimbra University Hospital Centre, Coimbra, Portugal
Zulmira Santos
Affiliation:
Department of Psychiatry, Psycho-Oncology Unit, Coimbra University Hospital Centre, Coimbra, Portugal
Hugo Bastos
Affiliation:
Department of Psychiatry, Psycho-Oncology Unit, Coimbra University Hospital Centre, Coimbra, Portugal
Ana Cabral
Affiliation:
Department of Psychiatry, Psycho-Oncology Unit, Coimbra University Hospital Centre, Coimbra, Portugal
*
Address correspondence and reprint requests to: Lucília Oliveira, Department of Psychiatry, Coimbra University Hospital Centre. Praceta Professor Mota Pinto, 3000-075 Coimbra, Portugal. E-mail: [email protected].
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Abstract

Objective:

Doctor–patient communication in oncology, particularly concerning diagnostic disclosure, is a crucial factor related to the quality of the doctor–patient relationship and the psychological state of the patient. The aims of our study were to investigate physicians' opinions and practice with respect to disclosure of a cancer diagnosis and to explore potential related factors.

Method:

A self-report questionnaire developed for our study was responded to by 120 physicians from Coimbra University Hospital Centre and its primary healthcare units.

Results:

Some 91.7% of physician respondents generally disclosed a diagnosis, and 94.2% were of the opinion that the patient knowing the truth about a diagnosis had a positive effect on the doctor–patient relationship. A need for training about communicating with oncology patients was reported by 85.8% of participants. The main factors determining what information to provide to patients were: (1) patient intellectual and cultural level, (2) patient desire to know the truth, and (3) the existence of family.

Significance of results:

Our results point to a paradigm shift in communication with cancer patients where disclosure of the diagnosis should be made part of general clinical practice. Nevertheless, physicians still experience difficulties in revealing cancer diagnoses to patients and often lack the skills to deal with a patient's emotional responses, which suggests that more attention needs to be focused on communication skills training programs.

Keywords

Cancer disclosurePortugalCommunication skillsDoctor–patient relationship
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 4 , August 2015 , pp. 1031 - 1036
Copyright
Copyright © Cambridge University Press 2014 

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References

REFERENCES

Atesci, F.C., Baltalarli, B., Oguzhanoglu, N.K., et al. (2004). Psychiatric morbidity among cancer patients and awareness of illness. Supportive Care in Cancer, 12, 161–167.Google ScholarPubMed
Fallowfield, L.J., Jenkins, V.A. & Beveridge, H.A. (2002). Truth may hurt but deceit hurts more: Communication in palliative care. Palliative Medicine, 16, 297–303.CrossRefGoogle ScholarPubMed
Ferraz, G.J. & Castro, S. (2001). Diagnosis disclosure in a Portuguese oncological centre. Palliative Medicine, 15, 35–41.Google Scholar
Fujimori, M. & Uchitomi, Y. (2009). Preferences of cancer patients regarding communication of bad news: A systematic literature review. Japanese Journal of Clinical Oncology, 39, 201–216.CrossRefGoogle ScholarPubMed
Gonçalves, J.F., & Castro, S. (2001). Diagnosis disclosure in a Portuguese oncological centre. Palliative Medicine, 15, 35.CrossRefGoogle Scholar
Grassi, L., Travado, L., Gil, F., et al. (2005). A communication: Intervention for training Southern European oncologists to recognize psychosocial morbidity in cancer patients, I: Development of the model and preliminary results on physicians' satisfaction. Journal of Cancer Education, 20, 79–84.CrossRefGoogle ScholarPubMed
Henriksson, M.M., Isometsa, E.T., Hietanen, P.S., et al. (1995). Mental disorders in cancer suicides. Journal of Affective Disorders, 36, 11–21.CrossRefGoogle ScholarPubMed
Holland, J.C., Geary, N., Marchini, A., et al. (1987). International survey of physician attitudes and practice in regard to revealing the diagnosis of cancer. Cancer Investigation, 5, 51–54.CrossRefGoogle ScholarPubMed
Loge, J.H., Kaasa, S., Ekeberg, O., et al. (1996). Attitudes toward informing the cancer patient: A survey of Norwegian physicians. European Journal of Cancer, 32, 1344–1348.CrossRefGoogle Scholar
Mitchell, J.L. (2005). Cross-cultural issues in the disclosure of cancer. Cancer Practice, 6, 153–160.CrossRefGoogle Scholar
Miyata, H., Takahashi, M., Saito, T., et al. (2005). Disclosure preferences regarding cancer diagnosis and prognosis: To tell or not to tell? Journal of Medical Ethics, 31, 447–451.CrossRefGoogle ScholarPubMed
Mystakidou, K., Parpa, E., Tsilila, E., et al. (2004). Cancer information disclosure in different cultural contexts. Supportive Care in Cancer, 12, 147–154.CrossRefGoogle ScholarPubMed
Novack, D.H., Plumer, R., Smith, R.L., et al. (1979). Changes in physicians' attitudes toward telling the cancer patient. The Journal of the American Medical Association, 241, 897–900.CrossRefGoogle ScholarPubMed
Oken, D. (1961). What to tell cancer patients: A study of medical attitudes. The Journal of the American Medical Association, 175, 1120–1128.CrossRefGoogle ScholarPubMed
Oksuzoglu, B., Abali, H., Bakar, M., et al. (2006). Disclosure of cancer diagnosis to patients and their relatives in Turkey: Views of accompanying persons and influential factors in reaching those views. Tumori, 92, 62–66.CrossRefGoogle ScholarPubMed
Panagopoulou, E., Mintziori, G., Montgomery, A., et al. (2008). Concealment of information in clinical practice: Is lying less stressful than telling the truth? Journal of Clinical Oncology, 26, 1175–1177.CrossRefGoogle ScholarPubMed
Pimentel, F.L., Ferreira, J.S. & Vila Real, M. (1999). Quantity and quality of information desired by Portuguese cancer patients. Supportive Care in Cancer, 7, 407–412.CrossRefGoogle ScholarPubMed
Pratt, L. & Seligman, A. (1957). Physician's view on the level of medical information among patients. American Journal of Public Health, 47, 1277.CrossRefGoogle Scholar
Santos, Z., Santos, G. & Abrantes, P. (1994). Comunicação médico-doente em oncologia. Acta Medica Portuguesa, 7, 361–365.Google Scholar
Smith, J.T. & Swisher, K. (1998). Telling the truth about terminal cancer. The Journal of the American Medical Association, 279, 1746–1748.CrossRefGoogle ScholarPubMed
Snyder, L. & Leffler, C. (2005). Ethics manual: Fifth edition. Annals of Internal Medicine, 142, 560–582.CrossRefGoogle ScholarPubMed
Surbone, A. (2004). Persisting differences in truth telling throughout the world. Supportive Care in Cancer, 12, 143–146.CrossRefGoogle ScholarPubMed