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Chiou YG, Chen SY, Wu LM, Lotus Shyu YI, Chiang YC, Hsiao CC, Wu HC, Tang WR. Experiences and preferences of truth-telling in families of children with cancer: A phenomenological study. Asia Pac J Oncol Nurs 2024; 11:100500. [PMID: 38933686 PMCID: PMC11203385 DOI: 10.1016/j.apjon.2024.100500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/27/2024] [Indexed: 06/28/2024] Open
Abstract
Objective The delivery of bad news is an unpleasant but necessary medical procedure. However, few studies have addressed the experiences and preferences of the families of school-aged children with cancer when they are informed of the children's condition. This study aimed to explore families of school-age children with cancer for their preferences and experiences of truth-telling. Methods This descriptive phenomenological qualitative research was conducted using focus group interviews and semistructured interview guidelines were adopted for in-depth interviews. Fifteen families participated in the study. The data were analyzed using Colaizzi's analysis. Data were collected from August 2019 to May 2020. Results The study identified two major themes: "caught in a dilemma" and "kind and comprehensive team support." The first major theme focused on families' experiences with cancer truth-telling. Three sub-themes emerged: (1) cultural aspects of cancer disclosure, (2) decision-making regarding informing pediatric patients about their illness, and (3) content of disclosure after weighing the pros and cons. The second major theme, which revealed families' preferences for delivering bad news, was classified into three sub-themes: (1) have integrity, (2) be realistic, and (3) be supportive. Conclusions This study underscores the dilemma encountered by the families of children with cancer after disclosure and their inclination toward receiving comprehensive information and continuous support. Health care personnel must improve their truth-telling ability in order to better address the needs of such families and to provide continuous support throughout the truth-telling process.
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Affiliation(s)
- Yen-Gan Chiou
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Ying Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Min Wu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yea-Ing Lotus Shyu
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yi-Chien Chiang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Chih-Cheng Hsiao
- Division of Hematology/Oncology, Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Hui-Chuan Wu
- Department of Post Baccalaureate Nursing, College of Medicine, I-SHOU University, Kaohsiung, Taiwan
| | - Woung-Ru Tang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Nephrology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Xu H, Yuan M. Family roles in informed consent from the perspective of young Chinese doctors: a questionnaire study. BMC Med Ethics 2024; 25:2. [PMID: 38172849 PMCID: PMC10765650 DOI: 10.1186/s12910-023-00999-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Based on the principle of informed consent, doctors are required to fully inform patients and respect their medical decisions. In China, however, family members usually play a special role in the patient's informed consent, which creates a unique "doctor-family-patient" model of the physician-patient relationship. Our study targets young doctors to investigate the ethical dilemmas they may encounter in such a model, as well as their attitudes to the family roles in informed consent. METHODS A questionnaire was developed including general demographic characteristics, the fulfillment of the obligation to fully inform, who will be informed, and the ethical dilemmas in decision-making. We recruited a total of 421 doctors to complete this questionnaire, of which 368 met the age requirements for this study. Cross tabulation and Pearson's chi-squared test were used to analyze the differences between types of patients for categorical variables, and a p-value < 0.05 was considered statistically significant. RESULTS Our data shows that only 20 doctors (5.40%) stated "informing the patient alone is sufficient" when it comes to informing patients of their serious conditions. The rest of the participants would ensure that the family was informed. When facing elderly patients with decision-making capacity, the data was statistically different (3.8%; P < 0.001) The primary reason for ensuring that family members be informed differs among the participants. In addition, when family members asked doctors to conceal the patient's medical condition for the best interests of patients, 270 doctors (73.4%) would agree and cooperate with the family. A similar proportion (79.6%) would do so when it comes to elderly patients. CONCLUSIONS (1) Chinese doctors pay extra attention to informing the patient's family, which may not be in the patient's best interests. (2) Chinese doctors treat adult (but not elderly) patients and elderly patients differently when it comes to informing family members. (3) When family members request that doctors withhold information from patients "in the best interest of the patient," the majority choose to comply with the request, although this may cause them distress.
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Affiliation(s)
- Hanhui Xu
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Mengci Yuan
- School of Medicine, Nankai University, Tianjin, 300071, China.
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Edwards WF, Malik S, Peters J, Chippendale I, Ravits J. Delivering Bad News in Amyotrophic Lateral Sclerosis: Proposal of Specific Technique ALS ALLOW. Neurol Clin Pract 2022; 11:521-526. [PMID: 34992959 DOI: 10.1212/cpj.0000000000000957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 04/24/2020] [Indexed: 12/13/2022]
Abstract
Purpose of Review Physician communication skills are a critical part of care for amyotrophic lateral sclerosis (ALS) patients and caregivers. They shape the development of autonomy and quality of life, and they mitigate emotional trauma. Communication skills are especially critical at 2 different time points in the course of the disease: early when delivering and establishing the diagnosis, and later when clarifying goals of care. Recent Findings Several techniques for physician communication of difficult information are available, including SPIKES (Setting up the interview, assessing the patient's Perception, obtaining the patient's Invitation, giving Knowledge and information to the patient, addressing the patient's Emotions with Empathetic responses, and Strategy and Summary), ABCDE (Advance preparation, Build a therapeutic environment/relationship, Communicate well, Deal with patient and family reactions, Encourage and validate emotions), and BREAKS (Background, Rapport, Exploring, Announce, Kindling, Summarize). These emphasize the physician's accountability and responsibility for communicating effectively. Formal training in these techniques is limited, and their applicability specifically to ALS is inexact. Summary We propose an ALS-specific technique which we call ALS ALLOW to guide physicians in conducting difficult communications with ALS patients and caregivers to develop their understanding, establish autonomy, set goals, and mitigate emotional trauma. The techniques are useful in discussions both early and late stages in the disease.
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Affiliation(s)
- Wesleigh F Edwards
- University of California San Diego School of Medicine (WFE, SM, JP, IC, JR); Department of Internal Medicine (WFE), Scripps Green Hospital and Clinic, La Jolla, CA; Cooper Medical School of Rowan University (SM), Camden, NJ; Department of Neurosciences (JP, JR), University of California, San Diego; and University of New England College of Osteopathic Medicine (IC), Biddeford, ME
| | - Sahana Malik
- University of California San Diego School of Medicine (WFE, SM, JP, IC, JR); Department of Internal Medicine (WFE), Scripps Green Hospital and Clinic, La Jolla, CA; Cooper Medical School of Rowan University (SM), Camden, NJ; Department of Neurosciences (JP, JR), University of California, San Diego; and University of New England College of Osteopathic Medicine (IC), Biddeford, ME
| | - Jonathan Peters
- University of California San Diego School of Medicine (WFE, SM, JP, IC, JR); Department of Internal Medicine (WFE), Scripps Green Hospital and Clinic, La Jolla, CA; Cooper Medical School of Rowan University (SM), Camden, NJ; Department of Neurosciences (JP, JR), University of California, San Diego; and University of New England College of Osteopathic Medicine (IC), Biddeford, ME
| | - Ivy Chippendale
- University of California San Diego School of Medicine (WFE, SM, JP, IC, JR); Department of Internal Medicine (WFE), Scripps Green Hospital and Clinic, La Jolla, CA; Cooper Medical School of Rowan University (SM), Camden, NJ; Department of Neurosciences (JP, JR), University of California, San Diego; and University of New England College of Osteopathic Medicine (IC), Biddeford, ME
| | - John Ravits
- University of California San Diego School of Medicine (WFE, SM, JP, IC, JR); Department of Internal Medicine (WFE), Scripps Green Hospital and Clinic, La Jolla, CA; Cooper Medical School of Rowan University (SM), Camden, NJ; Department of Neurosciences (JP, JR), University of California, San Diego; and University of New England College of Osteopathic Medicine (IC), Biddeford, ME
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Anuk D, Alçalar N, Sağlam EK, Bahadır G. Breaking bad news to cancer patients and their families: Attitudes toward death among Turkish physicians and their communication styles. J Psychosoc Oncol 2021; 40:115-130. [PMID: 34445939 DOI: 10.1080/07347332.2021.1969488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To investigate how Turkish oncologists' attitudes toward death influence their emotional states, outlooks, and communication styles when breaking bad news to cancer patients and/or their families. Cross-sectional study using self-completed questionnaires. The study sample consisted of 35 physicians working at an oncology department. Physicians completed a quantitative one-time survey developed by the authors and the Death Attitude Profile-Revised (DAP-R). Thirty-one physicians completed the survey and the DAP-R. A mean of 13.39 ± 8.82 minutes was allocated for breaking bad news; 87.1% of the participants avoided using the word "cancer" and 42% avoided using the word "death". The attitudes characterized by "death avoidance" and "fear of death" were found to be related to the emotional difficulty experienced by the physicians, and were also associated with less eye contact with the patient, and less attention paid to the language used while breaking bad news. It is important for physicians to be aware of how their attitudes toward death affect their communication with patients during bad news. They should be provided in-service professional education, and therapeutic support.
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Affiliation(s)
- Dilek Anuk
- Istanbul Faculty of Medicine, Department of Psychiatry, Consultation Liaison Division, Istanbul University, Istanbul, Turkey
| | - Nilüfer Alçalar
- Istanbul Faculty of Medicine, Department of Psychiatry, Consultation Liaison Division, Istanbul University, Istanbul, Turkey
| | - Esra Kaytan Sağlam
- Radiation Oncology Division Capa, Istanbul University Oncology Institute, Istanbul, Turkey
| | - Güler Bahadır
- Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul University, Istanbul, Turkey
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Ribeiro KG, Batista MH, Souza DFOD, Florêncio CMGD, Jorge WHA, Raquel CP. Comunicação de más notícias na educação médica e confluências com o contexto da pandemia de covid-19. SAUDE E SOCIEDADE 2021. [DOI: 10.1590/s0104-12902021201058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo O artigo apresenta um estudo exploratório descritivo sobre habilidades de Comunicação de Más Notícias (CMN) de internos de Medicina. Investigou-se a percepção discente sobre aprendizagem para CMN com delineamento transversal e abordagem mista. Houve aplicação de questionário, obtendo 176 participantes, e grupo focal com 12 estudantes. Os dados foram analisados pelo cálculo das médias e desvios-padrão para variáveis quantitativas e as falas do grupo focal foram submetidas à Análise de Conteúdo. Observou-se o dobro da frequência com mais habilidade para CMN no grupo que teve treinamento em comparação ao que não teve. No manejo da CMN, considerou-se mais difícil “ser honesto, sem tirar a esperança” (69%) e “lidar com a emoção do paciente” (59%). 99,4% conheciam o protocolo SPIKES, destes 41,5% consideraram a expressão de emoções sua etapa mais difícil. A comunicação e o manejo das emoções foram apontados como desafios na relação médico-paciente, com déficits no ensino de CMN. Obteve-se que a CMN não se limita à técnica, mas envolve atitudes que precisam ser abordadas com metodologias diversas, assim como requerem a implementação de políticas de educação na área médica, sobretudo diante das demandas emergentes da pandemia de Covid-19.
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Testoni I, Wieser MA, Kapelis D, Pompele S, Bonaventura M, Crupi R. Lack of Truth-Telling in Palliative Care and Its Effects among Nurses and Nursing Students. Behav Sci (Basel) 2020; 10:E88. [PMID: 32403378 PMCID: PMC7287675 DOI: 10.3390/bs10050088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 11/16/2022] Open
Abstract
Unclear communication of inauspicious prognoses may disorientate both patients and their relatives, drastically jeopardizing the planning of palliative care. This paper considers the issue of truth-telling in the communicative problems of nurses and students of nursing with terminally ill patients. The fundamental objective is the analysis of the difficulties related to the lack of truth-telling and how it might impact their professional and personal lives. A qualitative study was realized, involving 47 participants, both nurses (25) and nursing students (22), working in palliative care units or in associations of volunteers for the assistance of oncological patients. The exploration was focused on the way they relate to patients who are not aware of their real health conditions and their consequences. Particular attention was paid to their opinions concerning what could be done in order to manage such problematic situations in the near future.
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Affiliation(s)
- Ines Testoni
- Department of Philosophy, Sociology, Pedagogy and Applied psychology (FISPPA), University of Padova, 35131 Padova, Italy; (I.T.); (S.P.)
- Arts Therapies Research Center, University of Haifa, Haifa 3498838, Israel
| | | | - Dafni Kapelis
- Palliative Care Department, ULSS n. 8 Asolo, 31011 Treviso, Italy;
| | - Sara Pompele
- Department of Philosophy, Sociology, Pedagogy and Applied psychology (FISPPA), University of Padova, 35131 Padova, Italy; (I.T.); (S.P.)
| | | | - Robert Crupi
- NewYork-Presbyterian Queens, New York, NY 11355, USA;
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Rumpold T, Lütgendorf-Caucig C, Löffler-Stastka H, Roider-Schur S, Pötter R, Kirchheiner K. Attitude Towards End of Life Communication of Austrian Medical Students. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:743-748. [PMID: 29687186 DOI: 10.1007/s13187-018-1366-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Medical students have to acquire theoretical knowledge, practical skills, and a personal attitude to meet the emerging needs of palliative care. The present study aimed to assess the personal attitude of Austrian medical students towards end of life communication (EOLC), as key part of palliative care. This cross-sectional, mono-institutional assessment invited all medical students at the Medical University of Vienna in 2015. The assessment was conducted web-based via questionnaire about attitudes towards EOLC. Additional socio-demographic and medical education-related parameters were collected. Overall, 743 medical students participated in the present report. Differences regarding the agreement or disagreement to several statements concerning the satisfaction of working with chronically ill patients, palliative care, and health care costs, as well as the extent of information about palliative disease, were found for age, gender, and academic years. The overall attitude towards EOLC in the present sample can be regarded as quite balanced. Nevertheless, a considerable number of medical students are still reluctant to inform patients about their incurable disease. Reservations towards palliative care as part of the health care system seem to exist. The influence of the curriculum as well as practical experiences seems to be important but needs further investigation.
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Affiliation(s)
- Tamara Rumpold
- Department of Radiation Oncology, Comprehensive Cancer Center Medical University of Vienna, Waehringer Straße 18-20, 1090, Vienna, Austria
| | | | - Henriette Löffler-Stastka
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Waehringer Straße 18-20, 1090, Vienna, Austria
| | - Sophie Roider-Schur
- Division of Palliative Care, Department of Internal Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Waehringer Straße 18-20, 1090, Vienna, Austria
| | - Richard Pötter
- Department of Radiation Oncology, Comprehensive Cancer Center Medical University of Vienna, Waehringer Straße 18-20, 1090, Vienna, Austria
| | - Kathrin Kirchheiner
- Department of Radiation Oncology, Comprehensive Cancer Center Medical University of Vienna, Waehringer Straße 18-20, 1090, Vienna, Austria
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Cheng YH, Chen CH, Chen FJ, Huang EY, Liu PM, Kung CT, Huang HL, Yang LH, Chien PC, Hsieh CH. The training in SHARE communication course by physicians increases the signing of do-not-resuscitate orders for critical patients in the emergency room (cross-sectional study). Int J Surg 2019; 68:20-26. [PMID: 31185311 DOI: 10.1016/j.ijsu.2019.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/03/2019] [Accepted: 06/04/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Communication skills may be an important skill for the front-line emergency physicians. AIM This study aimed to investigate the effect of training in a SHARE communication course by emergency physicians on patient notification and signing of do-not-resuscitate (DNR) orders for critical patients in the emergency room. DESIGN From a total of 29 attending physicians in the emergency department, 19 physicians had been trained in the SHARE communication course. An observation form designed based on the SHARE training was completed by two observers who noted the communication process between physicians and patients and family members during patient notification and signing a DNR order. To assess the influence of physicians trained in a SHARE communication course on the signing of DNR orders, a propensity score-matched population was created to reduce the potential selection bias of patients and family members. SETTING Level 1 trauma medical center in southern Taiwan. RESULTS There were 145 individuals enrolled in the study, of which 93 signed the DNR order, and 52 did not sign it. Analysis from 23 matched pairs from this population revealed that significantly more family members would sign a DNR order if the physician had been trained in the SHARE communication course than when they did not receive this training (78.3% vs. 39.1%, respectively, p = 0.017). The overall score of the observation form for physicians was higher in those individuals who had signed a DNR order than in those who did not sign it (29.48 ± 3.72 vs. 26.13 ± 3.52, respectively, p = 0.003), especially when the physician had chosen a quiet environment (1.35 ± 0.65 vs. 0.87 ± 0.69, respectively, p = 0.020), understood the patient's wishes and confirmed them (1.78 ± 0.42 vs. 1.30 ± 0.70, respectively, p = 0.008), and expressed concern (1.48 ± 0.79 vs. 0.96 ± 0.77, respectively, p = 0.028). In addition, a feedback survey about the feelings experienced by these physicians during the process of patient notification did not reveal a significant difference during the communication with those who had or had not signed DNR orders. CONCLUSION The training in a SHARE communication course can improve the communication skills of emergency physicians in patient notification and signing of DNR orders for critical patients.
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Affiliation(s)
- Ya-Hui Cheng
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 833, Taiwan.
| | - Chih-Hung Chen
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 833, Taiwan; Graduate Institute of Adult Education, National Kaohsiung Normal University, Kaohsiung, 802, Taiwan.
| | - Fen-Ju Chen
- Department of Healthcare Administration, I-Shou University Medical Campus, 824, Taiwan.
| | - Eng-Yen Huang
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 833, Taiwan.
| | - Po-Ming Liu
- Department of Emergency Medicine, Yuan's General Hospital, 802, Taiwan.
| | - Chia-Te Kung
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 833, Taiwan.
| | - Hsien-Li Huang
- Graduate Institute of Adult Education, National Kaohsiung Normal University, Kaohsiung, 802, Taiwan; Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 833, Taiwan.
| | - Li-Hui Yang
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 833, Taiwan.
| | - Peng-Chen Chien
- Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 833, Taiwan.
| | - Ching-Hua Hsieh
- Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 833, Taiwan.
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Fan Z, Chen L, Meng L, Jiang H, Zhao Q, Zhang L, Fang CK. Preference of cancer patients and family members regarding delivery of bad news and differences in clinical practice among medical staff. Support Care Cancer 2018; 27:583-589. [DOI: 10.1007/s00520-018-4348-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 07/06/2018] [Indexed: 11/29/2022]
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Ni YH, Alræk T. What circumstances lead to non-disclosure of cancer-related information in China? A qualitative study. Support Care Cancer 2016; 25:811-816. [PMID: 27832368 PMCID: PMC5266771 DOI: 10.1007/s00520-016-3464-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 10/26/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Withholding information from cancer patients is a common practice in many Asian countries, including China, Japan, and Singapore, as well as in some Western countries, such as Spain, Greece, and Italy. Much research has investigated why doctors withhold information from cancer patients generally, both in the West and the East, but little research has been done on specifically why Chinese doctors withhold such information. METHODS Three focus group interviews were conducted with a total of 16 oncologists in China. The interviews were recorded, transcribed, and translated. Qualitative data were analyzed using systematic text condensation. RESULTS The result of this study revealed numerous circumstances that can lead to non-disclosure of cancer-related information. Many of these circumstances have been described in previous studies about non-disclosure in other countries. We found two additional circumstances that have not been described in previous literature and might therefore expand our current knowledge about this phenomenon; they are contradiction between laws and fear for personal safety. CONCLUSION Numerous circumstances can lead to non-disclosure of cancer-related information. This study found two additional circumstances that might lead to non-disclosure. The findings of this study suggest further assessment and clarification about the laws that govern doctor-patient communication and that action should be taken to ensure safe working environments for Chinese oncologists.
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Affiliation(s)
- Yi Hu Ni
- Department of Global Public Health and Primary Care, University of Bergen, Postboks 7804, Kalfarveien 31, 5020, Bergen, Norway.
| | - Terje Alræk
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Institute of Health Sciences, Kristiania University College, PB 1190 Sentrum, 0107, Oslo, Norway
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Tang WR, Hong JH, Rau KM, Wang CH, Juang YY, Lai CH, Fujimori M, Fang CK. Truth telling in Taiwanese cancer care: patients' and families' preferences and their experiences of doctors' practices. Psychooncology 2016; 26:999-1005. [DOI: 10.1002/pon.4257] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 06/24/2016] [Accepted: 08/05/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Woung-Ru Tang
- School of Nursing, College of Medicine; Chang Gung University; Taoyuan Taiwan
- Department of Psychiatry; Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - Ji-Hong Hong
- Department of Radiation Oncology; Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - Kun-Ming Rau
- Department of Hematology; Chang Gung Memorial Hospital; Kaohsiung Taiwan
| | - Cheng-Hsu Wang
- Department of Hematology; Chang Gung Memorial Hospital; Keelung Taiwan
| | - Yeong-Yuh Juang
- Department of Psychiatry; Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - Chien-Hong Lai
- Department of Hematology; Chang Gung Memorial Hospital; Keelung Taiwan
| | - Maiko Fujimori
- Center for Suicide Prevention, National Institute of Mental Health; National Center for Neurology & Psychiatry; Tokyo Japan
| | - Chun-Kai Fang
- Department of Psychiatry, Suicide Prevention Center & Hospice and Palliative Care Center; MacKay Memorial Hospital; Taipei Taiwan
- Department of Medicine; MacKay Medical College; New Taipei Taiwan
- Department of Thanatology and Health Counseling; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
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Cheng SY, Lin WY, Cheng YH, Huang CH, Chen CY, Hwang SJ, Tsai ST, Chiu TY. Cancer patient autonomy and quality of dying-a prospective nationwide survey in Taiwan. Psychooncology 2015; 25:179-86. [DOI: 10.1002/pon.3901] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 04/21/2015] [Accepted: 06/11/2015] [Indexed: 11/12/2022]
Affiliation(s)
- Shao-Yi Cheng
- Department of Family Medicine, College of Medicine and Hospital; National Taiwan University; Taipei Taiwan
| | - Wen-Yuan Lin
- Department of Family Medicine; China Medical University Hospital; Taichung Taiwan
- School of Medicine; China Medical University; Taichung Taiwan
| | - Ya-Hui Cheng
- Department of Family Medicine, Kaohsiung Medical University Hospital; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Chien Hsiun Huang
- Department of Community and Family Medicine; National Taiwan University Hospital Yun-Lin Branch; Yun-Lin Taiwan
| | - Ching-Yu Chen
- Department of Family Medicine, College of Medicine and Hospital; National Taiwan University; Taipei Taiwan
| | - Shinn-Jang Hwang
- Department of Family Medicine; Taipei Veterans General Hospital; Taipei Taiwan
- School of Medicine; National Yang-Ming University; Taipei Taiwan
| | - Shih-Tzu Tsai
- Center for Preventive Service, Hualien Tzu Chi Hospital; Buddhist Tzu Chi Medical Foundation; Hualien Taiwan
- College of Medicine; Tzu Chi University; Hualien Taiwan
| | - Tai-Yuan Chiu
- Department of Family Medicine, College of Medicine and Hospital; National Taiwan University; Taipei Taiwan
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Sarafis P, Tsounis A, Malliarou M, Lahana E. Disclosing the truth: a dilemma between instilling hope and respecting patient autonomy in everyday clinical practice. Glob J Health Sci 2013; 6:128-37. [PMID: 24576372 PMCID: PMC4825228 DOI: 10.5539/gjhs.v6n2p128] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 10/23/2013] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND While medical ethics place a high value on providing truthful information to patients, disclosure practices are far from being the norm in many countries. Transmitting bad news still remains a big problem that health care professionals face in their every day clinical practice. AIMS Through the review of relevant literature, an attempt to examine the trends in this issue worldwide will be made. METHOD Various electronic databases were searched by the authors and through systematic selection 51 scientific articles were identified that this literature review is based on. RESULTS There are many parameters that lead to the concealment of truth. Factors related to doctors, patients and their close environment, still maintain a strong resistance against disclosure of diagnosis and prognosis in terminally ill patients, while cultural influences lead to different approaches in various countries. Withholding the truth is mainly based in the fear of causing despair to patients. However, fostering a spurious hope, hides the danger of its' total loss, while it can disturb patient-doctor relationship.
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Affiliation(s)
- Pavlos Sarafis
- Faculty of Nursing, Technological Educational Institute of Sterea Ellada.
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Tang WR, Chen KY, Hsu SH, Juang YY, Chiu SC, Hsiao SC, Fujimori M, Fang CK. Effectiveness of Japanese SHARE model in improving Taiwanese healthcare personnel's preference for cancer truth telling. Psychooncology 2013; 23:259-65. [DOI: 10.1002/pon.3413] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 08/30/2013] [Accepted: 08/31/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Woung-Ru Tang
- School of Nursing, College of Medicine; Chang Gung University; Taoyuan Taiwan
| | - Kuan-Yu Chen
- Department of Psychiatry; Taipei City Hospital; Taipei Taiwan
| | - Sheng-Hui Hsu
- Department of Psychiatry; Koo Foundation Sun Yat-Sen Cancer Center; Taipei Taiwan
| | - Yeong-Yuh Juang
- Department of Psychiatry; Chang Gung Memorial Hospital at Linkou; Taoyuan Taiwan
| | - Shin-Che Chiu
- Department of Radiation Oncology; Mackay Memorial Hospital; Hsinchu Taiwan
| | - Shu-Chun Hsiao
- Cancer Control and promotion division, Bureau of Health Promotion; Department of Health; Taipei Taiwan
| | - Maiko Fujimori
- Psycho-Oncology Division, Research Center for Innovative Oncology; National Cancer Center Hospital East; Chiba Japan
| | - Chun-Kai Fang
- Department of Psychiatry and Suicide Prevention Center; Mackay Memorial Hospital; Taipei Taiwan
- Department of Medicine; Mackay Medical College; New Taipei Taiwan
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