Preferences of Malaysian Cancer Patients in Communication of Bad News

Tan, Chai-Eng; Yaakup, Hayati; Shah, Shamsul Azhar; Jaffar, Aida; Omar, Khairuddin

doi:10.7314/apjcp.2012.13.6.2749

Cited by 16 publications

(24 citation statements)

References 16 publications

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“…Data suggest that there is a lack of information available for patients to make an informed choice and patients and their parents are not actively involved in decision-making. Overall, despite patient’s desire for quality information [37,38,41] patients were not given enough information to make an informed choice [28,30,43]. Although healthcare professionals, mainly doctors, were aware of the importance of taking informed consent, some would choose not to practise it if diagnosis was unfavourable or if truth was deemed harmful [23,27].…”

Section: Resultsmentioning

confidence: 99%

An overview of patient involvement in healthcare decision-making: a situational analysis of the Malaysian context

Lee

et al. 2013

BMC Health Serv Res

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BackgroundInvolving patients in decision-making is an important part of patient-centred care. Research has found a discrepancy between patients’ desire to be involved and their actual involvement in healthcare decision-making. In Asia, there is a dearth of research in decision-making. Using Malaysia as an exemplar, this study aims to review the current research evidence, practices, policies, and laws with respect to patient engagement in shared decision-making (SDM) in Asia.MethodsIn this study, we conducted a comprehensive literature review to collect information on healthcare decision-making in Malaysia. We also consulted medical education researchers, key opinion leaders, governmental organisations, and patient support groups to assess the extent to which patient involvement was incorporated into the medical curriculum, healthcare policies, and legislation.ResultsThere are very few studies on patient involvement in decision-making in Malaysia. Existing studies showed that doctors were aware of informed consent, but few practised SDM. There was limited teaching of SDM in undergraduate and postgraduate curricula and a lack of accurate and accessible health information for patients. In addition, peer support groups and 'expert patient’ programmes were also lacking. Professional medical bodies endorsed patient involvement in decision-making, but there was no definitive implementation plan.ConclusionIn summary, there appears to be little training or research on SDM in Malaysia. More research needs to be done in this area, including baseline information on the preferred and actual decision-making roles. The authors have provided a set of recommendations on how SDM can be effectively implemented in Malaysia.

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Section: Resultsmentioning

confidence: 99%

An overview of patient involvement in healthcare decision-making: a situational analysis of the Malaysian context

Lee

et al. 2013

BMC Health Serv Res

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“…Numerous quantitative studies have explored the preferences of those receiving bad news internationally, mostly utilising questionnaires . Evidence from such studies suggests that across cultures, the majority of patients want to be informed of their diagnosis, would like the news delivered by a physician, and want the news to be given calmly in a private place .…”

Section: Introductionmentioning

confidence: 99%

“…10 Numerous quantitative studies have explored the preferences of those receiving bad news internationally, mostly utilising questionnaires. [11][12][13][14] Evidence from such studies suggests that across cultures, the majority of patients want to be informed of their diagnosis, 15 would like the news delivered by a physician, 14,16 and want the news to be given calmly in a private place. 15,17 However, such studies infrequently include family member preferences and, because of being surveybased, may be limited in their ability to provide a nuanced perspective on this complex process for the receivers of bad news.…”

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confidence: 99%

The experiences of patients and their family members when receiving bad news about cancer: A qualitative meta‐synthesis

et al. 2019

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Objective This qualitative meta‐synthesis explored the subjective experiences of patients and their family members when receiving bad news about cancer, with a focus on what was important to them during this process and making future recommendations. Methods A search of five electronic databases yielded 587 different records that resulted in 88 articles assessed against the inclusion/exclusion criteria. With the supplement of four additional records, 29 articles were analysed using thematic synthesis. A quality appraisal checklist was used to provide further information about the included articles. Results Patients and family members experienced receiving bad news as a process that involved three phases, labelled as follows: “preparation”, “delivery”, and “adjusting and coping”. The “preparation” phase had four themes: the setting, developing a relationship, knowing the patient, and forewarning. Four themes were identified during the “delivery” phase: emotional reactions, empathy not sympathy, active participation, and understanding. “Adjusting and coping” comprised four themes: hope, holistic support, being a protector, and ongoing relationships. Conclusions Receiving bad news is a significant experience for patients and family members. They want bad news delivered in an appropriate setting, in a manner consistent with their personal preferences, and have their psychological needs attended to within the context of an established relationship. Healthcare professionals can be assisted to deliver bad news in the best way possible by additional training and their workplace institutions providing quiet, private rooms, and sufficient time. Future research is needed to better understand family members' experiences and needs.

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“…A strong dependence on family members in Malay culture was described, supported by (Eng, et al, 2012), and corresponds to Malaysia being classed as a collectivist society (Hofstede, 2011). The strong emphasis placed on the family context, "we are closer to our families", even within the very first stage of the CS framework, suggests that setting the family scene warrants a more central focus in CS teaching in Malaysia.…”

Section: Deeper Conceptsmentioning

confidence: 99%

Transferring a medical curriculum to Malaysia

Alberti¹,

Delgaty²

2017

SE Asian Jnl Med Educ

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Objective: To explore the cultural challenges that emerge when delivering part of a Western medical curriculum (communication skills) in Malaysia and to generate possible solutions. The franchise of Western higher education programmes to the East is a growing phenomenon, yet there is a scarcity of discourse around curricular transfer. Methods: This was a qualitative, explorative, study drawing from the tradition of ethnography. Data collection included: participant observation, semi-structured interviews and focus group discussions. Thematic analysis followed Spradley's ethnographic technique of domain, taxonomic, componential and cultural analysis. Results: Thirty eight cultural themes emerged relating to three levels of challenge to teaching communication skills in Malaysia: Practical challenges, implementation challenges and deeper concepts. The practical level covered linguistic, translation and teaching material issues. The implementation level related to the challenge of implementing the taught communications skills (CS) into busy Malaysian clinical practice and clear differences in expectations of the doctor-patient consultation. Finally, more complex challenges to CS teaching emerged related to behavioural, emotional and cultural concepts. Conclusions: A novel conceptual framework classifying the challenges and offering potential solutions to CS teaching at NUMed has emerged based around three levels: Practical challenges including the 'localising' of content and contextual components of the course. Implementation challenges that highlight contextual differences that require further exploration within the Malaysian and other resourcelimited contexts. Deeper challenges that require local in-depth discussion and international study. This original conceptual framework addresses the complex issue of transferring curricula to cross-cultural contexts, facilitates further critical research and informs practice.

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Preferences of Malaysian Cancer Patients in Communication of Bad News

Cited by 16 publications

References 16 publications

An overview of patient involvement in healthcare decision-making: a situational analysis of the Malaysian context

An overview of patient involvement in healthcare decision-making: a situational analysis of the Malaysian context

The experiences of patients and their family members when receiving bad news about cancer: A qualitative meta‐synthesis

Transferring a medical curriculum to Malaysia

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