A recent study found that 20 percent of more than 2, physicians surveyed admitted that they had not told patients the truth when they had committed an error. Moreover, the study found that more than 10 percent had not discussed financial conflicts of interest with patients and 15 percent said they gave a more favorable picture about prognosis, risk, and and benefit with respect to a disease.
Received Aug 5; Accepted Jan This article has been cited by other articles in PMC. Abstract Background Evidence suggests that truth telling and honest disclosure of cancer diagnosis could lead to improved outcomes in cancer patients.
To examine such findings in Iran, this trial aimed to study the various dimensions of quality of life in patients with gastrointestinal cancer and to compare these variables among those who knew their diagnosis and those who did not.
Methods A consecutive sample of patients with gastrointestinal cancer being treated in Cancer Institute in Tehran, Iran was prospectively evaluated. Patients were categorized into two groups: Independent sample t-test was used for group comparisons.
Results In all patients were interviewed. They were quite similar in most characteristics. Performing analysis of variance while controlling for age, educational status, cancer site, and knowledge of cancer diagnosis, the results showed that the knowledge of cancer diagnosis independently still contributed to the significant differences observed between two groups.
Conclusion Contrary to expectation the findings indicated that patients who did not know their cancer diagnosis had a better physical, social and emotional quality of life. It seems that due to cultural differences between countries cancer disclosure guidelines perhaps should be differing.
Background A diagnosis of cancer often imposes a crisis, with the person having to confront the illness and its treatment, and deal with issues concerning the meaning of life, death, and an uncertain future [ 1 ]. While many argue that it is important to give patients this information so that they can make important decisions in an informed manner, others suggest that giving this sort of information can destroy hope.
Moreover, based on some broad cultural differences among those who hold one of these views, whether or not to tell the truth about diagnoses and prognoses in such situations has arguably come to symbolize the importance of cross-cultural differences in medical practice [ 34 ].
Cancer and its treatments often produce significant morbidities that undermine quality of life in survivors [ 5 ]. Quality of life QOL assessment is now considered as an important component of evaluation in chronic disease, particularly in cancer clinical trials [ 6 ].
There are few studies that investigate quality of life in cancer patients regarding knowledge of cancer diagnosis. According to a study from India, psychiatric morbidity is significantly lower in patients who are "unaware" of the diagnosis of cancer and who have a more hopeful outlook of the treatment [ 7 ].
A study performed in Turkey, indicated that psychiatric morbidity was significantly higher in patients who knew that they had a cancer diagnosis. These findings suggest that the awareness of cancer diagnosis is related to the presence of psychiatric morbidity [ 8 ].
On the contrary, some studies have shown that honest disclosure of the truth does not worsen any dimension of quality of life in general or emotional functioning in particular [ 910 ]. Since no studies has investigated the quality of life of Iranian patients regarding knowledge of cancer diagnosis, here we investigated about quality of life of Iranian cancer patients; and compared it among those who knew their diagnosis and those who did not.
Because of high incidence of esophageal and stomach cancer in Iran [ 11 ] it was decided to select gastrointestinal cancer patients in an attempt i to examine quality of life in these group of cancer patients and ii to compare these variables among those who knew their diagnosis and those who did not.
Methods Design and data collection An interview based prospective study was carried out to measure quality of life in patients with gastrointestinal cancer. Data were collected during November and April The intention was to interview all gastrointestinal cancer inpatients attending to a large teaching hospital Imam Hospital for their treatment in Tehran, Iran.
This was achieved at the end of each interview. First we asked relatives to indicate whether a patient knew his or her diagnosis. Then to confirm this with patients, after a careful consideration each patient was asked what was wrong with he or she.
Data on demographic characteristics and clinical information including age, gender, educational status, cancer site and time since diagnosis were extracted from case records. All participants in the study were gastrointestinal cancer patients who were diagnosed during one year ago.
Patients who had cognitive problems or were too sick to participate in the interview were excluded.
It incorporates five functional scales physical, role, cognitive, emotional, and socialthree symptom scales fatigue, pain and nausea and vomitingand a global health and quality of life scale. The remaining single items assess additional symptoms commonly reported by cancer patients dyspnoea, appetite loss, sleep disturbance, constipation, and diarrhea and also the perceived financial impact of the disease and treatment.
With the exception of two questions concerning physical condition and global quality of life that were rated on a 7-point scale, responses to all other questions were on a 4-point scale not at all, a little, quite a bit, very much. The reliability coefficient for multi-item scales reported to range from 0.
Validity performing known-groups comparison analysisalso showed that all the functional and symptom scales discriminated between subgroups of patients differing in clinical status as defined by their performance status and disease stage [ 13 ].
Statistical analysis In accordance with procedures recommended by the EORTC, score were linearly converted to a scale ranging from 0 and for each patient.Conclusions: Disclosure of LGBT identity is a common experience in the context of cancer care, and disclosure and support factors are associated with better self-reported health among LGBT patients.
Implications for Nursing: Creating safe environments for LGBT patients to disclose could improve cancer care delivery to this underserved population. Approach to Care: Cancer Crystal Fore Grand Canyon University: NRS v Pathophysiology and Nursing Management of Clients Health November 9, Approach to Care: Cancer Devastation and fear of the known are common feelings for those who receive news of having Cancer.
Disclosing the diagnosis or prognosis to cancer patients in Saudi Arabia can be a serious challenge to the physician in his daily clinic practice. The public attitude towards full disclosure is still conservative, and in order to appropriately deal with such an attitude, physicians need to deeply.
When Confidentiality is breeched, it may deter patients from seeking treatment for fear of disclosure of one’s personal information (Beech ).
Confidentiality can result in legal and professional problems, distrust, disrespect, and feelings of betrayal and or poor compliance with treatment.
The aims of this study were to analyze factors that may explain the non-disclosure of cancer diagnosis to patients by physicians and to compare personal characteristics of cancer patients, on the. -Disclosure of cancer diagnosis to patients is an ethical, sensitive and controversial issue in health care practice.
There have been several studies focusing on merits and shortcomings of informing patients about their diagnosis of cancer.