Tragic Knowledge: Truth Telling and the Maintenance of Hope in Surgery

Suri, Megha; McKneally, Martin F.; Devon, Karen

doi:10.1007/s00268-014-2566-3

Cited by 15 publications

(15 citation statements)

References 34 publications

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“…This is an important gap in knowledge considering that family plays an important role in Asian medical cultures 20,24,25 and many health care providers have indicated that predicaments in their truth-telling practice are mainly family related. 13,17,25,[37][38][39] This issue underscores the importance of our findings on Taiwanese family members' truth-telling preferences.…”

Section: Item-wise Analysis Of Truth-telling Scale Scoresmentioning

confidence: 62%

“…Although the importance of family has been emphasized during the truth‐telling process, none of these studies used validated instruments to investigate families' truth‐telling preferences. This is an important gap in knowledge considering that family plays an important role in Asian medical cultures and many health care providers have indicated that predicaments in their truth‐telling practice are mainly family related . This issue underscores the importance of our findings on Taiwanese family members' truth‐telling preferences.…”

Section: Discussionmentioning

confidence: 79%

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Truth telling in Taiwanese cancer care: patients' and families' preferences and their experiences of doctors' practices

et al. 2016

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Section: Item-wise Analysis Of Truth-telling Scale Scoresmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 79%

Truth telling in Taiwanese cancer care: patients' and families' preferences and their experiences of doctors' practices

et al. 2016

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“…While technological advancements have improved diagnostic and prognostic accuracy in emergency care, better accuracy does not necessarily assuage the difficulty of balancing truth and hope. 6 All of this is particularly challenging when communicating clinical equipoise, a situation where two or more treatment options exist but neither is clearly superior. Providers need to communicate uncertainty and adequate information on disease mechanism, estimation of prognosis, and risks and benefits of each treatment option for the patient to make an informed decision.…”

Section: Introductionmentioning

confidence: 99%

Communication at diagnosis of venous thromboembolism: Lasting impact of verbal and nonverbal provider communication on patients

Hernandez‐Nino

Thomas

Alexander

et al. 2022

Research and Practice in Thrombosis and Haemostasis

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Background Establishing trust and effective communication can be challenging in the emergency department, where a prior relationship between patient and provider is lacking and decisions have to be made rapidly. Venous thromboembolism (VTE) represents an emergent condition that requires immediate decision making. Objective The aim of this paper was to document the experiences, perceptions, and the overall impact of health care provider communication on patients during the diagnosis of VTE in the emergency department. Methods This was a qualitative method study using semistructured interviews to increase understanding of the patient experience during the diagnosis of VTE and impact of the health care provider communication on subsequent patient perceptions. Results A total of 24 interviews were conducted. Content analysis revealed that certain aspects of health care providers’ communication—namely, word choice, incomplete information, imbalance between fear over reassurance and nonverbal behavior—used to deliver and explain VTE diagnosis, treatment, and prognosis increases patients’ fears. Conclusion These interviews elucidate areas for improvement of communication in the emergency care setting for acute VTE.

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“…Physicians and nurses still struggle to find the best way to tell bad news without causing undue harm to the patients. 3,6…”

Section: Introductionmentioning

confidence: 99%

Differences in practice and preferences associated with truth-telling to cancer patients

Wu¹,

Wang²,

Jiao³

et al. 2020

Nurs Ethics

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Background: Doctors should disclose the diagnosis to patients according to the principle of autonomy. However, not disclosing the diagnosis and prognosis to cancer patients remains common in mainland China. Objective: The study explored the experiences and attitudes of patients with cancer, family members, and the medical staff in truth-telling. Research design: A quantitative survey with three closed-ended questionnaires was conducted. Participants: In all, 137 patients with cancer, 134 family members caring for cancer cases, and 54 medical staff were surveyed. Descriptive statistics were used to summarize all characteristics, and the chi-square test was performed to analyze group differences in attitudes toward cancer disclosure. Ethical considerations: This study was approved by the Committee on Ethics of Biomedicine Research, at the Second Military Medical University (HJEC-2018-YF-001). Informed consent was obtained from all participants prior to study commencement. Findings: A total of 59.8% of patients were informed about their diagnosis within 1 week, and 19.7% inferred theirs. The medical staff preferred to prioritize family members in informing about patient diagnosis while 77.4% of patients preferred to be told the whole truth at the time of initial diagnosis. More patients than family members and medical staff wanted the patients to be informed about the diagnosis ( p < 0.001). A significant difference was found between the patients and family members regarding who should tell the patients. Discussion: The willingness of patients in knowing the truth was underestimated by their family members as well as the medical staff. Guessing the truth indirectly may exert negative effects on the patients, and not telling the truth is inappropriate in patients who want to be informed. Conclusion: Disclosure of a cancer diagnosis is a complex process involving medical practice, as well as a range of cultural, ethical, and legal factors. The medical staff should first assess each patient’s willingness in truth-telling and inform about disease diagnosis with respect. Emotional support and comfort from family members are encouraged. Anyone in the patient’s care team, especially nurses, could be integrated in the process of truth-telling.

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Tragic Knowledge: Truth Telling and the Maintenance of Hope in Surgery

Cited by 15 publications

References 34 publications

Truth telling in Taiwanese cancer care: patients' and families' preferences and their experiences of doctors' practices

Truth telling in Taiwanese cancer care: patients' and families' preferences and their experiences of doctors' practices

Communication at diagnosis of venous thromboembolism: Lasting impact of verbal and nonverbal provider communication on patients

Differences in practice and preferences associated with truth-telling to cancer patients

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