Responding to family requests for nondisclosure: The impact of oncologists′ cultural background

Chittem, Mahati; Butow, Phyllis

doi:10.4103/0973-1482.140836

Cited by 26 publications

(33 citation statements)

References 24 publications

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“…This is the norm in western cultures (Seifart et al., ) and is reflected around the world through an increasing trend towards full patient disclosure (Chaturvedi et al., ; Ichikura et al., ). Our findings are in contrast with recent reports from Canada (Oliffe, Thorne, Hislop & Armstrong, ) and Australia (Chittem & Butow, ) that suggest that cancer patients from non‐Western cultures may prefer less information and do not desire full disclosure. Like Gautam and Nijhawan () two decades ago, we found that majority of Indian patients want to be told the truth.…”

Section: Discussioncontrasting

confidence: 99%

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Pivotal role of families in doctor-patient communication in oncology: a qualitative study of patients, their relatives and cancer clinicians

et al. 2016

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Families are a unique source of support for many cancer patients. Most advanced communication skills training for oncologists are patient centred and do not cover interactions with family members. The current study used in-depth qualitative interviews of patients, relatives and cancer clinicians with thematic analysis to explore the role of family members in the communication process. Forty-one participants included 10 cancer patients, 10 relatives ensuring proportionate representation of both gender and primary cancer site and 21 doctors representing both medical and surgical oncology. Nineteen of 20 patients and relatives wanted an "open and honest" discussion with their doctors. All patients, relatives and doctors preferred involvement of the family at most stages of cancer treatment. Five themes were identified in relation to communication with family members. The participants highlighted the "importance of family for physical and psychological care," they emphasised the need to "balance patient autonomy and relatives desire to be protective" using varied "negotiating strategies" that are influenced by "socioeconomic circumstances of both patient and family." The doctor-patient-relative communication process was not static with preferences changing over time. The data suggests that communication skills training of cancer clinicians should incorporate modules on better communication with relatives.

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Section: Discussioncontrasting

confidence: 99%

“…Australia (Chittem & Butow, 2015) that suggest that cancer patients from non-Western cultures may prefer less information and do not desire full disclosure. Like Gautam and Nijhawan (1987) two decades ago, we found that majority of Indian patients want to be told the truth.…”

Section: Discussionmentioning

confidence: 99%

Pivotal role of families in doctor-patient communication in oncology: a qualitative study of patients, their relatives and cancer clinicians

et al. 2016

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“…Research conducted by Savio and George (Naveen & Anice, 2013) mentioned that nurses have difficulty talking to someone who has a distinct cultural and linguistic background. Another study conducted by Chittem and Butow (2015) stated that the language differences could lead to misunderstanding in interpreting the information provided. Therefore, in the nursefamily relationship mutual respect is needed to be able to minimize misunderstanding due to differences in cultural culture and language.…”

Section: Discussionmentioning

confidence: 99%

Nurses’ Reflections on Challenges and Barriers of Communication in the Intensive Care Unit: A Phenomenology Study

et al. 2020

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Communication among nurses, patients, and families takes an important role in the intensive care unit in which the patients are in critical condition and unable to involve in two-way communication. Research related to effective nurse-patient communication has been done extensively, but the information regarding communication in intensive care unit is still limited. This research aimed to explore nurses’ experiences in the intensive care units in effective communication to patients/patient’s families. This was a qualitative study project with phenomenology approach. The data were collected using the in-depth interview technique approximately 60 minutes involving ten nurses who were selected using the purposive sampling at Al Islam Hospital Bandung. Data were analysed using the Colaizzi method and the results were presented in themes. Based on the nurses’ experiences, four themes were emerged in this study including (1) Nurses’ dilemma of their professionalism and personal issues/matters, (2) Contextual factor affects selection of nurses' communication technique, (3) Barriers in effective communication; difficulties in accompanying families to accept critical patient conditions, care and treatment procedures in the ICU which were complicated, and misunderstanding between nurse-patient and family (4) Compassion and patience are required in nurse-patient communication in ICU. The complex patient/family conditions in the ICU require nurses to choose the appropriate communication technique accompanied by a sense of compassion and patience. Nurses need to improve their ability to communicate effectively in order to lower the barriers in communicating between nurses-patients/families. Recommendations, training and assistance of effective communication become important for nurses in improving services in the Intensive Care Unit.

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“…47,49–54 These and other cultural differences are commonly cited as barriers to appropriate end-of-life care. 55 Additional literature suggests how Western HCPs should respond to noncollusion requests.…”

Section: Alternative Perspectivesmentioning

confidence: 99%

Truth Telling in the Setting of Cultural Differences and Incurable Pediatric Illness

et al. 2017

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IMPORTANCE-Navigating requests from parents or family caregivers not to disclose poor prognosis to seriously ill children can be challenging, especially when the requests seem culturally mediated. Pediatric clinicians must balance obligations to respect individual patient autonomy, professional truth telling, and tolerance of multicultural values.OBSERVATIONS-To provide suggestions for respectful and ethically appropriate responses to nondisclosure requests, we used a hypothetical case example of a Middle Eastern adolescent patient with incurable cancer and conducted an ethical analysis incorporating (1) evidence from both Western and Middle Eastern medical literature and (2) theories of cultural relativism and justice. While Western medical literature tends to prioritize patient autonomy and corresponding truth telling, the weight of evidence from the Middle East suggests high variability between and within individual countries, patient-physician relationships, and families regarding truth-telling practices and preferences. A common reason for nondisclosure in both populations is protecting

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Responding to family requests for nondisclosure: The impact of oncologists′ cultural background

Cited by 26 publications

References 24 publications

Pivotal role of families in doctor-patient communication in oncology: a qualitative study of patients, their relatives and cancer clinicians

Pivotal role of families in doctor-patient communication in oncology: a qualitative study of patients, their relatives and cancer clinicians

Nurses’ Reflections on Challenges and Barriers of Communication in the Intensive Care Unit: A Phenomenology Study

Truth Telling in the Setting of Cultural Differences and Incurable Pediatric Illness

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