How doctors record breaking bad news in ovarian cancer

Kirwan, John; Tincello, Douglas G.; Lavender, Tina; Kingston, Robert E.

doi:10.1038/sj.bjc.6600816

Cited by 16 publications

(7 citation statements)

References 12 publications

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“…Relatives often ask that a serious diagnosis be withheld from older people, 3 and physicians sometimes collude with them in maintaining secrecy. 13 However, several reports 3,14 have shown that agreement between the preferences of relatives and those of patients regarding truth disclosure was not significantly greater than that expected by chance alone. For example, we have found that three quarters of relatives who asked that a patient not be told of their diagnosis were in conflict with the patient's wishes.…”

Section: Discussionmentioning

confidence: 92%

Advance Directives for Truth Disclosure

Keating¹,

Nayeem

Gilmartin³

et al. 2005

Chest

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Section: Discussionmentioning

confidence: 92%

Advance Directives for Truth Disclosure

Keating¹,

Nayeem

Gilmartin³

et al. 2005

Chest

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“…Two retrospective studies retrieved the prognostic communication details while in-person telephonic interviews were conducted in two studies using medical records. 34 – 36 In comparison, the combination of methods such as interviews and records or interviews and ward observation or interview and home visits was used in five studies. 8 , 18 , 37 , 38 Almost all the studies with face-to-face or telephonic interviews used audiotaped recordings of verbatim of the triad involved, and subsequently, most of the qualitative studies used grounded theory procedures for analysis of the transcripts.…”

Section: Resultsmentioning

confidence: 99%

Prognostic disclosure in cancer care: a systematic literature review

Sutar

Chaudhary

2022

Palliat�Care

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Background: Collusion in cancer care is the diplomatic concealment of information between a triad of the health care professional (HCP), patient, and caregiver. Free and expressive communication is determined by multiple factors, which establishes a healthy balance between ‘patient-centric’ and ‘family-centric’ decision making. The lack of a universal approach to prognostic disclosure techniques emphasizes the need for a systematic review of contemporary practice. Methods: A systematic review of the literature was conducted till June 2020 using themes based on cancer, communication, prognostic disclosure, and collusion by using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Fifty-three studies involving 10,569 subjects were studied for their utility on prognostic disclosure using different communication methods and interfaces. Twenty-three studies used a face-to-face interview with subjects while in-person telephonic interviews were conducted in two studies, 16 studies implicated semi-structured questionnaires, and 6 studies mentioned the development of a new technique/tool for disclosure. The duration of a session for prognosis-disclosure ranged from 22 min to 1 h. The involvement of palliative care specialists and mental health professionals was limited during the disclosure of the prognosis. Conclusion: The findings of the review indicate that patients in cancer care are aware of their diagnosis and to a certain extent of prognosis despite nondisclosure by their family members and treating teams. This review emphasizes the assessment of ‘disclosure wishes’ among patients and caregivers in separate interviews rather than simply relying on one specific method of interviewing. The nonconfrontational approach and training among HCPs are of utmost importance to build therapeutic resilience among the treating team involved in cancer care. Since many factors such as family wishes, cultural dissonance, medical model, and patient perception could become barriers to prognostic disclosure, there is a need to develop a universal approach to prognostic disclosure and handling associated collusion.

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“…Full texts of 126 articles were screened. A total of 27 studies fulfilled eligibility criteria and were thus eligible for inclusion in this systematic review and meta‐analysis 2,3,8‐32 . Table 1 shows the characteristics of included studies with the prevalence of collusion.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of collusion in cancer communications: A meta‐analysis

2021

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Introduction Collusion is the non‐disclosure of information about diagnosis or prognosis, frequently encountered in cancer care and palliative services. Unraveling collusion is a skill and differences among communication techniques by Health Care Workers have maintained the process of non‐disclosure to patients and caregivers. Identifying the prevalence of collusion in cancer care is required to improve the existing strategies across the world. Methods A systematic review of the literature from 1991 to 2020 in the English language was conducted with the protocol registration on PROSPERO ID (CRD 42021249216.) to identify the pooled prevalence of collusion. Results By using random effect model, the pooled prevalence estimate among patients for the diagnostic and prognostic collusion was 24.15, (95% CI [17.09; 32.96], Tou2 = 1.0801, I2 = 97.9%, Cochran's Q = 1058.22, df = 21, p‐value < 0.001) and 37.92, (95% CI [22.46; 56.30], Tou2 = 1.9641, I2 = 98.6%, Cochran's Q = 944.26, df = 13, p‐value < 0.001) respectively. There was no difference across subgroups with different types of setting for the interview, WHO regions and trend over the years. Conclusions Substantial prevalence of collusion goes unnoticed in cancer care. A meaningful understanding of such a large prevalence requires inquiry into the existing communication paradigm in cancer care across the world. The findings also question the need of formulating uniform interview techniques and structured assessment tools or questionnaires in cancer care to improve the disclosure rates.

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How doctors record breaking bad news in ovarian cancer

Cited by 16 publications

References 12 publications

Advance Directives for Truth Disclosure

Advance Directives for Truth Disclosure

Prognostic disclosure in cancer care: a systematic literature review

Prevalence of collusion in cancer communications: A meta‐analysis

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