Factors associated with a preference for disclosure of life expectancy information from physicians: a cross-sectional survey of cancer patients undergoing radiation therapy
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This study aimed to investigate experiences and preferences for disclosure of life expectancy, agreement between them, and the factors associated with preferences for disclosure of life expectancy with physicians among cancer patients undergoing radiation therapy.
Cancer patients aged 20 years or older were consecutively sampled when they started radiation therapy at two university hospitals. Patients completed self-administered questionnaires concerning their experiences of and preferences for disclosure of life expectancy, treatment decision-making, psychological distress, physical symptoms, sociodemographic and medical factors, physician’s communication style, and provision of psychological, physical, and practical support.
Among the 226 respondents (response rate: 58%) who responded, 54% experienced disclosure of life expectancy, and 45% preferred it. The agreement is 65%. Eighty-five percent recognized their aim of radiation therapy as curative. A univariate analysis indicated that having a full/part-time job and wishing to leave treatment decisions to doctors were significantly associated with preference for disclosure of life expectancy, but psychological distress was not. A multiple regression analysis revealed that having a full-time/part-time job was significantly associated with preference of communication about life expectancy.
Fifty-four percent of the patients experienced and 45% of the patients preferred disclosure of life expectancy. The agreement is moderate. Our results show that there was a significant association between employment status and patient’s preference for disclosure of life expectancy with physicians. Communication of prognosis is difficult but whether a patient continues to work or not may be an indicator of preference.
KeywordsLife expectancy Prognosis Radiation therapy Doctor-patient communication Cancer
We wish to thank Emiko Miyazaki, Shinsaku Endo, Masayo Kadota, Kyoko Yanagi, Yasuko Kimura, and Asako Yamato for their contribution to the survey as research assistants and Rob Sanson-Fisher for their support in the development of the international quality of cancer care comparison study.
This study was supported by a Grant-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, and Science.
Compliance with ethical standards
The study protocol was approved by the Institutional Review Board and Ethics Committee of Nagoya City University Graduate School of Medical Sciences and Kyoto University Hospital. It was conducted in accordance with the principles of the Declaration of Helsinki. Written consent was obtained from each patient after the study was explained to them.
Conflict of interest
The authors declare that they have no conflict of interest.
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