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Supportive Care in Cancer

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01-08-2009 | Original Article

Non-disclosure of cancer diagnosis: an examination of personal, medical, and psychosocial factors

Author: Csaba L. Dégi

Published in: Supportive Care in Cancer | Issue 8/2009

Abstract

Objectives

In recent psycho-oncological literature, few studies are concerned with the consequences of cancer diagnosis non-disclosure. 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 basis of cancer diagnosis disclosure versus non-disclosure.

Methods

A total of 420 hospitalized cancer patients were included in our study; 342 with malignant and 78 with benign tumors. Two hundred thirty-eight women and 185 men completed a self-report questionnaire that included standardized measures of depressive symptoms (BDI), hopelessness, ways of coping, negative life events and anomie. Data were controlled for demographic, medical, and psychosocial factors.

Results

Malignant cancer (OR:11.88), severe and moderate depression (OR:10.57 and OR:4.81), lack of chemotherapy (OR:4.20) and low anomie (OR:2.77) after overall adjustment predicted cancer diagnosis non-disclosure to patients.

Conclusion

Our results underline the persistent need for delivering patient-focused health services in oncological care based on respect for the patients’ right to autonomy.

Butow PN, Kazemi JN, Beeney LJ, Griffin A, Dunn SM, Tattersall MHN (1996) When the diagnosis is cancer: patient communication experiences and preferences. Cancer 77(12):2630–2637 doi:10.1002/(SICI)1097-0142(19960615)77:12<2630::AID-CNCR29>3.0.CO;2-S PubMedCrossRef

Bailey RK, Geyen DJ, Scott-Gurnell K, Hipolito MMS, Bailey TA, Beal JM (2005) Understanding and treating depression among cancer patients. Int J Gynecol Cancer 15:203–208 doi:10.1111/j.1525-1438.2005.15204.x PubMedCrossRef

Massie MJ (2004) Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr 32:57–71 doi:10.1093/jncimonographs/lgh014 PubMedCrossRef

Folkman S, Lazarus R (1980) An analysis of coping in a middle aged community sample. J Health Soc Behav 21:219–239 doi:10.2307/2136617 PubMedCrossRef

Kopp M (2006a) A pszichoszociális tényezők jelentősége, különös tekintettel a megelőzésre. In: Onkopszichológia a gyakorlatban. Medicina, Budapest, pp 42–50

Riskó Á (2006) A daganatos betegség különböző fázisaiban az alkalmazkodás pszichoszociális jellemzői. In: Onkopszichológia a gyakorlatban. Medicina, Budapest, pp 85–92

Siminoff LA, Ravdin P, Colabianchi N, Sauders-Sturm CM (2000) Doctor–patient communication patterns in breast cancer adjuvant therapy discussions. Health Expect 3:26–36 doi:10.1046/j.1369-6513.2000.00074.x PubMedCrossRef

Lin CC (1999) Disclosure of the cancer diagnosis as it relates to the quality of pain management among patients with cancer pain in Taiwan. J Pain Symptom Manage 18(5):331–337 doi:10.1016/S0885-3924(99)00091-3 PubMedCrossRef

Roberts CS, Cox CE, Reintgen DS, Baile WF, Gibertini M (1994) Influence of physician communication on newly diagnosed breast patients’ psychologic adjustment and decision-making. Cancer 74:336–341PubMedCrossRef

10.

Roter D (1989) Which facets of communication have strong effects on outcome—a meta-analysis. In: Communicating with medical patients. Sage, Newbury Park, pp 183–196

11.

Sardell AN, Trierweiler SJ (1993) Disclosing the cancer diagnosis. Cancer 72:3355–3365 doi:10.1002/1097-0142(19931201)72:11<3355::AID-CNCR2820721135>3.0.CO;2-D PubMedCrossRef

12.

Fallowfield LJ, Baum M, Maguire GP (1986) Effects of breast conservation on psychological morbidity associated with diagnosis and treatment of early breast cancer. Br Med Bull 293:1331–1334

13.

Holland JC, Geary N, Marchini A, Tross S (1987) An international survey of physician attitudes and practice in regard to revealing the diagnosis of cancer. Cancer Invest 5:151–154 doi:10.3109/07357908709018468 PubMedCrossRef

14.

Mystakidou K, Parpa E, Tsilika E, Katsouda E, Vlahos L (2004) Cancer information disclosure in different cultural contexts. Support Care Cancer 12:147–154 doi:10.1007/s00520-003-0552-7 PubMedCrossRef

15.

Faria SL, Souhami L (1997) Communication with the cancer patient: information and truth in Brazil. Ann N Y Acad Sci 809:163–171 doi:10.1111/j.1749-6632.1997.tb48079.x PubMedCrossRef

16.

Torrecillas L (1997) Communication of the cancer diagnosis to Mexican patients. Ann N Y Acad Sci 809:188–196 doi:10.1111/j.1749-6632.1997.tb48082.x PubMedCrossRef

17.

Hospice Romania (2008) Campanie nationala de constientizare a problemelor cu care se confrunta pacientii cu boli grave in stadii avansate—Planul de servicii paliative. http://www.hospice.ro. Cited 24 February 2008

18.

Esbensen BA, Swane CE, Hallberg IR, Thome B (2008) Being given a cancer diagnosis in old age: a phenomenological study. Int J Nurs Stud 45(3):393–405 doi:10.1016/j.ijnurstu.2006.09.004 PubMedCrossRef

19.

Maynard DW (2006) “Does it mean I’m gonna die?” On meaning assessment in the delivery of diagnostic news. Soc Sci Med 62(8):1902–1916 doi:10.1016/j.socscimed.2005.09.011 PubMedCrossRef

20.

Baile WF, Lenzi R, Kudelka AP, Maguire P, Novack D, Goldstein M, Myers EG, Bust RC Jr (1997) Improving physician–patient communication in cancer care: outcome of a workshop for oncologists. J Cancer Educ 12:166–173PubMed

21.

Fallowfield L, Jenkins V (1999) Effective communication skills are the key to good cancer care. Eur J Cancer 35:1592–1597 doi:10.1016/S0959-8049(99)00212-9 PubMedCrossRef

22.

Horikawa N, Yamazaki T, Sagawa M, Nagata T (2000) Changes in disclosure of information to cancer patients in a general hospital in Japan. Gen Hosp Psychiatry 22:37–42 doi:10.1016/S0163-8343(99)00042-0 PubMedCrossRef

23.

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571PubMed

24.

Kopp M, Falger P, Appels A, Szedmák S (1998) Depression and vital exhaustion are differentially related to behavioural risk factors for coronary heart disease. Psychosom Med 60:752–758PubMed

25.

Kopp MS, Skrabski Á, Szedmák S (2000) Psychosocial risk factors, inequality and self-rated morbidity in a changing society. Soc Sci Med 51:1350–1361 doi:10.1016/S0277-9536(00)00097-6 CrossRef

26.

Beck AT, Weissman A, Lester D, Trexler L (1974) The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol 42:861–865 doi:10.1037/h0037562 PubMedCrossRef

27.

Perczel-Forintos D, Sallai J, Rózsa S (2001) A Beck-féle Reménytelenség Skála pszichometriai vizsgálata. Psychiatr Hung 16(6):632–643

28.

Kopp M, Skrabski Á (1992) Magyar lelkiállapot. Végeken Alapítvány, Budapest

29.

Rahe RH, Tolles RL (2002) The brief stress and coping inventory: a useful stress management Instrument. Int J Stress Manag 9:61–70 doi:10.1023/A:1014950618756 CrossRef

30.

Kopp M, Skrabski Á, Szedmák S (1999) A testi és lelki egészség összefüggései országos reprezentatív felmérések alapján. Demografia 17(1–2):88–119

31.

Cox A, Jenkins V, Catt S, Langridge C, Fallowfield L (2006) Information needs and experiences: an audit of UK cancer patients. Eur J Oncol Nurs 10(4):263–272 doi:10.1016/j.ejon.2005.10.007 PubMedCrossRef

32.

Pronzato P, Bertelli G, Losardo P, Landucci M (1994) What do advanced cancer patients know of their disease? A report from Italy. Support Care Cancer 2(4):242–244 doi:10.1007/BF00365729 PubMedCrossRef

33.

Annunziata MA (1997) Ethics of relationship. From communication to conversation. Ann N Y Acad Sci 809:400–410 doi:10.1111/j.1749-6632.1997.tb48103.x PubMedCrossRef

34.

Mystakidou K, Parpa E, Tsilika E, Kalaidopoulou O, Vlahos L (2002) The families’ evaluation on management, care and disclosure for terminal stage cancer patients. BMC Palliat Care 1:3 doi:10.1186/1472-684X-1-3 PubMedCrossRef

35.

Gotay CG (1996) Cultural variation in family adjustment to cancer. In: Cancer and the family. Wiley, New York, pp 31–49

36.

Phungrassami T, Sriplung H, Roka A, Mintrasak E, Peerawong T, Aegem U (2003) Disclosure of a cancer diagnosis in Thai patients treated with radiotherapy. Soc Sci Med 57(9):1675–1682 doi:10.1016/S0277-9536(02)00552-X PubMedCrossRef

37.

Wang SY, Chen CH, Chen YS, Huang HL (2004) The attitude toward truth telling of cancer in Taiwan. J Psychosom Res 57(1):53–58 doi:10.1016/S0022-3999(03)00566-X PubMedCrossRef

38.

Horikawa N, Yamazaki T, Sagawa M, Nagata T (1999) The disclosure of information to cancer patients and its relationship to their mental state in a consultation–liaison psychiatry setting in Japan. Gen Hosp Psychiatry 21:368–373 doi:10.1016/S0163-8343(99)00026-2 PubMedCrossRef

39.

Mallinger J, Griggs J, Shields C (2005) Patient-centered care and breast cancer survivors’ satisfaction with information. Patient Educ Couns 57:342–349 doi:10.1016/j.pec.2004.09.009 PubMedCrossRef

40.

Davidson JR, Brundage MD, Feldman-Stewart D (1999) Lung cancer treatment decisions: patients’ desires for participation and information. Psychooncology 8:511–520 doi:10.1002/(SICI)1099-1611(199911/12)8:6<511::AID-PON415>3.0.CO;2-T PubMedCrossRef

41.

Grassi L, Indelli M, Marzola M, Maestri A, Santini A, Piva E, Boccalon M (1996) Depression and quality of life in home care assisted cancer patients. J Pain Symptom Manage 12:300–307 doi:10.1016/S0885-3924(96)00181-9 PubMedCrossRef

42.

Henriksson MM, Isometsa ET, Hietanen PS, Aro HM, Lonnqvist JK (1995) Mental disorders in cancer suicides. J Affect Disord 36:11–20 doi:10.1016/0165-0327(95)00047-X PubMedCrossRef

43.

Pirl WF, Roth AJ (1999) Diagnosis and treatment of depression in cancer patients. Oncology 13:1293–1302 1305–1306PubMed

44.

Gidron Y, Russ K, Tissarchondou H, Warner J (2006) The relation between psychological factors and DNA-damage: a critical review. Biol Psychol 72:291–304 doi:10.1016/j.biopsycho.2005.11.011 PubMedCrossRef

45.

Irie M, Miyata M, Kasai H (2005) Depression and possible cancer risk due to oxidative DNA damage. J Psychiatr Res 39:553–560 doi:10.1016/j.jpsychires.2005.01.009 PubMedCrossRef

46.

Kopp M, Skrabski A, Szanto Z, Siegrist J (2006b) Psychosocial determinants of premature cardiovascular mortality differences within Hungary. J Epidemiol Community Health 60(9):782–788 doi:10.1136/jech.2005.042960 PubMedCrossRef

47.

Persson L, Hallberg IR (2004) Lived experience of survivors of leukemia or malignant lymphoma. Cancer Nurs 27:303–313 doi:10.1097/00002820-200407000-00007 PubMedCrossRef

48.

Tiedje L, Holzman CB, De Vos E, Jia X, Korzeniewski S, Rahbar MH, Goble MM, Kallen D (2008) Hostility and anomie: links to preterm delivery subtypes and ambulatory blood pressure at mid-pregnancy. Soc Sci Med 66:1310–1321PubMed

49.

Skrabski A, Kopp M, Kawachi I (2003) Social capital in a changing society: cross-sectional associations with middle-aged female and male mortality rates. J Epidemiol Community Health 57(2):114–119 doi:10.1136/jech.57.2.114 PubMedCrossRef

50.

Kvale K (2007) Do cancer patients always want to talk about difficult emotions? A qualitative study of cancer inpatients communication needs. Eur J Oncol Nurs 11(4):320–327 doi:10.1016/j.ejon.2007.01.002 PubMedCrossRef

Title: Non-disclosure of cancer diagnosis: an examination of personal, medical, and psychosocial factors
Author: Csaba L. Dégi
Publication date: 01-08-2009
Publisher: Springer-Verlag
Published in: Supportive Care in Cancer / Issue 8/2009
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-008-0568-0

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Abstract

Objectives

Methods

Results

Conclusion

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