Supportive Care in Cancer

, Volume 12, Issue 7, pp 497–502 | Cite as

“Do not tell”: what factors affect relatives’ attitudes to honest disclosure of diagnosis to cancer patients?

  • Mustafa Ozdogan
  • Mustafa Samur
  • Hakan Sat Bozcuk
  • Erkan Coban
  • Mehmet Artac
  • Burhan Savas
  • Arzu Kara
  • Zekiye Topcu
  • Yeliz Sualp
Original Article

Abstract

Disclosure of the diagnosis of cancer to patients is a difficult task for physicians in developing countries. Family members often oppose truth telling. The aim of this study was to evaluate the incidence of the “do not tell” attitude in a general population of cancer patients and to explore the factors affecting the attitude of cancer patients’ relatives about honest disclosure. Using a questionnaire, relatives of 150 patients with recently diagnosed cancer were interviewed. Of the relatives, 66% did not want the diagnosis to be disclosed. Male gender of the patient, a diagnosis of a non-breast cancer malignancy, the presence of stage IV disease, no previous request for disclosure by the patient, insufficient knowledge of the relative about cancer in general, and stronger religious belief of the relative were associated with greater likelihood of the relative having a “do not tell” attitude in univariate analyses (P=0.032, P=0.000, P=0.051, P=0.021, P=0.128, and P=0.058, respectively). In a multivariate analysis, the diagnosis of a non-breast cancer malignancy, and insufficient knowledge of the relative about cancer in general retained their significance (exp(B)=14.77, P=0.000; exp(B)=3.04, P=0.01, respectively). Differences among different countries and cultures are discussed.

Keywords

Cancer Relatives Disclosure Do not tell Truth telling 

References

  1. 1.
    Butow PN, Tattersall MH, Goldstein D (1997) Communication with cancer patients in culturally diverse societies. Ann N Y Acad Sci 809:317–329PubMedGoogle Scholar
  2. 2.
    Bozcuk H, Erdoğan V, Eken C, Çıplak E, Samur M, Özdoğan M, Savaş B (2002) Does awareness of the diagnosis make any difference in quality of life? Determinants of emotional functioning in a group of cancer patients in Turkey. Support Care Cancer 10:51–57CrossRefPubMedGoogle Scholar
  3. 3.
    Thomsen OO, Wulff HR, Martin A, Singer PA (1993) What do gastroenterologists in Europe tell cancer patients? Lancet 341:473–476PubMedGoogle Scholar
  4. 4.
    Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP (2000) SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist 5:302–311PubMedGoogle Scholar
  5. 5.
    Ali NS, Khalil HZ, Yousef W (1993) A comparison of American and Egyptian cancer patients’ attitudes and unmet needs. Cancer Nurs 16:193–203PubMedGoogle Scholar
  6. 6.
    Hu WY, Chiu TY, Chuang RB, Chen CY (2002) Solving family-related barriers to truthfulness in cases of terminal cancer in Taiwan. A professional perspective. Cancer Nurs 25:486–492CrossRefPubMedGoogle Scholar
  7. 7.
    Butow PN, Maclean M, Dunn SM, Tattersall MH, Boyer MJ (1997) The dynamics of change: cancer patients’ preferences for information, involvement and support. Ann Oncol 8:857–863Google Scholar
  8. 8.
    Younge D, Moreau P, Ezzat A, Gray A (1997) Communicating with cancer patients in Saudi Arabia. Ann N Y Acad Sci 809:309–316PubMedGoogle Scholar
  9. 9.
    Mystakidou K, Liossi C, Vlachos L, Papadimitriou J (1996) Disclosure of diagnostic information to cancer patients in Greece. Palliat Med 10:195–200PubMedGoogle Scholar
  10. 10.
    Loge JH, Kaasa S, Ekeberg O, Falkum E, Hytten K (1996) Attitudes toward informing the cancer patient—a survey of Norwegian physicians. Eur J Cancer 32A:1344–1348CrossRefPubMedGoogle Scholar
  11. 11.
    Grassi L, Giraldi T, Messina EG, Magnani K, Valle E, Cartei G (2000) Physicians’ attitudes to and problems with truth-telling to cancer patients. Support Care Cancer 8:40–45PubMedGoogle Scholar
  12. 12.
    Noone I, Crowe M, Pillay I, O’Keeffe ST (2000) Telling the truth about cancer: views of elderly patients and their relatives. Ir Med J 93:104–105PubMedGoogle Scholar
  13. 13.
    Meredith C, Symonds P, Webster L, Lamont D, Pyper E, Gillis CR, Fallowfield L (1996) Information needs of cancer patients in west Scotland: cross sectional survey of patients’ views. BMJ 313:724–726PubMedGoogle Scholar
  14. 14.
    Leydon GM, Boulton M, Moynihan C, Jones A, Mossman J, Boudioni M, McPherson K (2000) Cancer patients’ information needs and information seeking behaviour: in depth interview study. BMJ 320:909–913CrossRefPubMedGoogle Scholar
  15. 15.
    Merrouche Y, Freyer G, Saltel P, Rebattu P (1996) Quality of final care for terminal cancer patients in a comprehensive cancer centre from the point of view of patients’ families. Support Care Cancer 4:163–168PubMedGoogle Scholar
  16. 16.
    Sen M (1997) Communication with cancer patients: the influence of age, gender, education and health insurance status. Ann N Y Acad Sci 809:514–524PubMedGoogle Scholar
  17. 17.
    Eraker SA, Kirscht JP, Becker MH (1984) Understanding and improving patient compliance. Ann Intern Med 100:258–268PubMedGoogle Scholar
  18. 18.
    Stewart MA (1995) Effective physician-patient communication and health outcomes: a review. CMAJ 152:1423–1433PubMedGoogle Scholar
  19. 19.
    Friedrichsen MJ, Strang PM, Carlsson ME (2001) Receiving bad news: experiences of family members. J Palliat Care 17:241–247PubMedGoogle Scholar
  20. 20.
    Ringdal GI, Jordhoy MS, Kaasa S (2002) Family satisfaction with end-of-life care for cancer patients in a cluster randomized trial. J Pain Symptom Manage 24:53–63PubMedGoogle Scholar
  21. 21.
    Ringdal GI, Jordhoy MS, Kaasa S (2003) Measuring quality of palliative care: psychometric properties of the FAMCARE scale. Qual Life Res 12:167–176CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Mustafa Ozdogan
    • 1
  • Mustafa Samur
    • 1
  • Hakan Sat Bozcuk
    • 1
  • Erkan Coban
    • 1
  • Mehmet Artac
    • 1
  • Burhan Savas
    • 1
  • Arzu Kara
    • 2
  • Zekiye Topcu
    • 2
  • Yeliz Sualp
    • 2
  1. 1.Medical Oncology, Internal MedicineAkdeniz UniversityTurkey
  2. 2.Medical Oncology Nursing Staff, Internal MedicineAkdeniz UniversityTurkey

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