Factors influencing the attitudes and behaviors of oncologists regarding the truthful disclosure of information to patients with advanced and incurable cancer

Abstract

Objective: To evaluate the attitudes of the European Oncologists to information disclosure to patients with advanced cancer, their self-reported behaviors, and the factors that influence both attitudes and behaviors.Methods: ESMO members were invited to complete an online questionnaire to evaluate both attitudes and clinical behaviors relating to the disclosure of information to patients with advanced cancer. Data were analyzed to evaluate demographic, educational and social factors influencing attitudes and behaviors.Results: Two hundred and ninety-eight completed surveys were returned. The survey demonstrated strong internal consistency construct validity. The responses indicate that individual clinicians generally display a range of behaviors including non-disclosive as well as disclosive behaviors depending on the dynamics of individual interactions between oncologist and specific patient. Although regional cultural norms influence oncologists' attitudes toward disclosure and, indirectly, their self-reported behaviors, the impact is influenced by other factors: in particular, perceived institutional professional norms, the degree of training in breaking bad news and the frequency of exposure to requests by family members to withhold information from the patient.Conclusions: Positive attitudes regarding disclosure of information to patients and disclosive behaviors can be encouraged, even in non-Western countries, by the development of strong professional norms and education in breaking bad news and coping with the emotional responses of patients.

Information Provision and Patient Reported Outcomes in Patients with Metastasized Colorectal Cancer: Results from the PROFILES Registry

“…7,8,16,18,19 However, a recent study showed that oncologists are often unwilling, unable, or uncomfortable with honestly disclosing and discussing information regarding diagnosis and prognosis with patients with advanced disease. 20 In addition, many HCPs avoid discussing the topic or withhold information. 21 Furthermore, HCPs tend to underestimate patients' need for information and overestimate patients' understanding of their prognosis.…”

Increasing the number of patients receiving information about transition to end-of-life care: the effect of a half-day physician and nurse training

“…Education and training has been suggested by Rogg et al 19 and Cherny20 as methods to change physicians’ attitudes towards disclosure of prognostic information. Friedrichsen et al 7 found that when healthcare staff were educated about communicating transition to end-of-life care, they expressed frustration because economic constraints made it difficult to incorporate their new knowledge into their clinical work.…”

ESMO gave me a chance to help make a difference: a personal reflection on the occasion of receiving the 2015 ESMO Award

“…This study, published in 2010, 9 highlighted the importance of education and the institutional culture of care within individual hospitals as major factors influencing oncologist's practices of disclosure and communication (box 2).…”

“…This has been a challenging project on many levels: intellectually, scientifically and even philosophically. It has involved multiple incarnations, extensive and rigorous field testing and Box 2 Major findings from the ESMO communication survey 9 Based on responses from 298 oncologists across all regions of Europe, the study indicated that individual clinicians generally display a range of behaviours, including non-disclosive as well as disclosive behaviours, depending on the dynamics of individual interactions between oncologist and specific patient. Although regional cultural norms influence oncologists' attitudes towards disclosure and, indirectly, their self reported behaviours, the impact is influenced by other factors: in particular, perceived institutional professional norms, the degree of training in breaking bad news and the frequency of exposure to requests by family members to withhold information from the patient.…”