scholarly journals To Tell or Not to Tell: Exploring the Preferences and Attitudes of Patients and Family Caregivers on Disclosure of a Cancer-Related Diagnosis and Prognosis

2019 ◽  
pp. 1-12
Author(s):  
Arunangshu Ghoshal ◽  
Naveen Salins ◽  
Anuja Damani ◽  
Jayeeta Chowdhury ◽  
Arundhati Chitre ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Response Rate ◽  
Additional Treatment ◽  
Adult Patients ◽  
Full Disclosure ◽  
Course Of Illness ◽  
Patients With Cancer ◽  
Diagnosis And Prognosis ◽  
Expected Length ◽  
Indian Setting

PURPOSE To understand the preferences and attitudes of patients and family caregivers on disclosure of cancer diagnosis and prognosis in an Indian setting. METHODS Overall, 250 adult patients with cancer and 250 family caregivers attending the outpatients of a tertiary cancer hospital for the first time were recruited purposively. The mean ages of patients and caregivers were 49.9 years (range, 23-80 years) and 37.9 years (range, 19-67 years), respectively. Separately, they completed prevalidated, close-ended preference questions and were interviewed for open-ended attitude questions. RESULTS A total of 250 adult patients (response rate, 47.17% overall, 73.2% in men, and 26.8% in women) and 250 family caregivers (response rate, 40.65% overall, 84.0% in men, and 16.0% in women) participated. Significant differences were observed in the preference to full disclosure of the name of illness between patients (81.2%) and caregivers (34.0%) and with the expected length of survival between patients (72.8%) and caregivers (8.8%; P < .001). The patients felt that knowing a diagnosis and prognosis may help them be prepared, plan additional treatment, anticipate complications, and plan for future and family. The caregivers felt that patients knowing a diagnosis and prognosis may negatively affect the future course of illness and cause patients to experience stress, depression, loss of hope, and confidence. CONCLUSION Patients with cancer preferred full disclosure of their diagnoses and prognoses, whereas the family caregivers preferred nondisclosure of the same to their patients. This novel information obtained through a large study with varied participants from different parts of the country will help formulate communication strategies for cancer care.

scholarly journals Would the Saudi Family Agree to Tell the Truth to Cancer Patient? Exploring Awareness, Perception, and Attitude to Truth Telling.

2021 ◽  
Author(s):  
MOHAMMAD ABOSOUDAH ◽  
Balaji Duraisamy
Keyword(s):  
Family Caregivers ◽  
Family Members ◽  
Bad News ◽  
Confirmatory Test ◽  
Breaking Bad News ◽  
Do Not Resuscitate ◽  
Full Disclosure ◽  
Code Status ◽  
Breaking Bad ◽  
Diagnosis And Prognosis

Abstract Aim:To study the differences in attitude and perceptions of patients versus family members with regards to breaking bad news and full disclosure of prognosis to the patients in a tertiary care center in Saudi Arabia. Methods:A survey of patients and their family members was conducted in the oncology outpatient clinics using a structured questionnaire. Based on the existing prevalence of patients who wanted full disclosure, the sample size was calculated to be 143. Demographic details, diagnostic details were collected in addition to responses to questions exploring attitudes towards breaking bad news. A total of 149 patients and family members were interviewed separately. Results:A total of 149 patients and their family members consented to be interviewed. However, only valid responses to each question were analyzed. Overall, 75.2% (109/145) of patients felt that patient should be informed first as compared to 72.9% (102/140) of family members who felt the family should be informed of the bad news first. 24.3% (34) of family caregivers agreed that patients have the right to full disclosure. Both patients and family caregivers were reluctant to know details about the code status. 71.4% (95) of family caregivers and 54.3% (75) of the patients did not want the health care team to discuss details of code status and DNR. Both patients (87.1%) and caregivers (74.3%) agreed that the primary physician is the best person to break the bad news. Family members may be emotionally more affected than patients. They might require as much if not more support as the patients themselves during breaking bad news.Conclusions:There are significant differences between patient and family members regarding full disclosure of diagnosis and prognosis especially, end-of-life issues like DNR and place of death. The most stressful time for the patient was waiting for confirmatory test results. Therefore, breaking bad news support services should systematically begin even before diagnostic investigations begin. Our study points out that the majority of patients want to know the full details of diagnosis and prognosis. Discussion regarding code status has to be more structured in a way that the patient and family do not feel abandoned due to the Do Not Resuscitate status. Further study is needed to study the need and efficacy of a breaking bad news system in the hospital.

Rising Economic Impact of Clostridium difficile-Associated Disease in Adult Hospitalized Patient Population

2008 ◽  
Vol 29 (9) ◽  
pp. 823-828 ◽  
Author(s):  
Xiaoyan Song ◽  
John G Bartlett ◽  
Kathleen Speck ◽  
April Naegeli ◽  
Karen Carroll ◽  
...  
Keyword(s):  
At Risk ◽  
Mortality Rate ◽  
Clostridium Difficile ◽  
Economic Burden ◽  
Excess Mortality ◽  
Tertiary Care ◽  
Severity Of Illness ◽  
Adult Patients ◽  
Care Hospital ◽  
Course Of Illness

Background.Clostridium difficile-associated disease (CDAD) is responsible for increased morbidity and a substantial economic burden. Incidences of CDAD, including those with a severe course of illness, have been increasing rapidly.Objective.To evaluate the excess mortality, increased length of stay (LOS) in the hospital, and additional costs associated with CDAD.Design.A retrospective matched cohort study.Patients.Adult patients admitted to a large tertiary care hospital between January 2000 and October 2005.Methods.Adult patients were tested with a C. difficile laboratory assay at admission or 72 hours after admission. Infected patients had lor more positive assay results and were individually matched to 1 uninfected patient who had negative assay results, by exposure time, age, ward, and at least 2 measurements for comorbidity and severity of illness.Results.The incidence rate of CDAD among adult patients increased from 0.57 cases per 1,000 patient-days at risk before 2004 to 0.88 cases per 1,000 patient-days at risk after 2004 (P < .001). The 630 infected patients had a mortality rate of 11.9%; the 630 uninfected patients had a mortality rate of 15.1% (P = .02). After adjustment in the multivariate analysis, we found that the LOS for infected patients was 4 days longer than that for uninfected patients (P < .001). If CDAD occurred after 2004, the additional LOS increased to 5.5 days. The direct cost associated with CDAD was $306 per case; after year 2004, it increased to $6,326 per case.Conclusions.There may be no excess mortality among patients with CDAD, compared with patients without it, but the economic burden of CDAD is increasing. By 2004, CDAD-associated medical expenditures approached $1,000,000 per year at our institution alone.

Qualitative Analysis of the Experience of Mental Fatigue of Family Caregivers of Patients With Cancer in Phase I Trials

2016 ◽  
Vol 43 (4) ◽  
pp. E153-E160 ◽  
Author(s):  
Denise Weiss ◽  
Laurel Northouse ◽  
Sonia Duffy ◽  
Berit Ingersoll-Dayton ◽  
Maria Katapodi ◽  
...  
Keyword(s):  
Qualitative Analysis ◽  
Phase I ◽  
Family Caregivers ◽  
Mental Fatigue ◽  
Phase I Trials ◽  
Patients With Cancer

Abstract 1221: The landscape of 2,706 RET alterations from 89,754 adult patients with cancer: Clinical implications

2021 ◽  
Author(s):  
Jacob J. Adashek ◽  
Alexander Andreev-Drakhlin ◽  
Jason Roszik ◽  
Aakash P. Desai ◽  
Vivek Subbiah
Keyword(s):  
Adult Patients ◽  
Clinical Implications ◽  
Patients With Cancer

scholarly journals Patients’ understanding of clinical research: An Italian cancer patient survey

2018 ◽  
Vol 105 (1) ◽  
pp. 31-37
Author(s):  
Britt Rudnas ◽  
Emanuela Montanari ◽  
Monia Dall’Agata ◽  
Elisabetta Petracci ◽  
Oriana Nanni
Keyword(s):  
Clinical Research ◽  
Response Rate ◽  
Medical Oncology ◽  
Patient Survey ◽  
Research Knowledge ◽  
Patients With Cancer ◽  
Trial Experience ◽  
Clinical Trial Experience ◽  
Previous Clinical Trial ◽  
Level Of Knowledge

Introduction: Patients’ awareness of clinical research and their involvement in clinical trials is of great importance, but it is difficult to estimate the extent of knowledge on the research being undertaken. Methods: We evaluated the level of knowledge about clinical research using a self-reporting survey distributed to 967 adult patients with cancer attending the Departments of Medical Oncology and Onco-Haematology Units of IRST IRCCS and 4 hospitals in the region of Emilia-Romagna, Italy. The questionnaire was composed of 10 specific items on research knowledge. Patients responding correctly to at least 8 of the 10 items were considered to have a good understanding of clinical research. Results: The questionnaire was completed by 769 patients (response rate 79.5%). Only 19% of patients were found to have a good understanding of clinical research. Patients with higher education and those who had previous clinical trial experience showed a significantly better understanding. Fifty-three percent of patients said that they would be willing to participate in a trial studying a new drug and 75% expressed an interest in taking part in informative meetings/events about clinical studies. Conclusions: Our results show that patients’ understanding of clinical research is limited and highlight an interest in learning more.

Achievement of a good death among young adult patients with cancer: analyses of combined data from three nationwide surveys among bereaved family members

2018 ◽  
Vol 27 (4) ◽  
pp. 1519-1527
Author(s):  
Masanori Mori ◽  
Tomoyo Sasahara ◽  
Tatsuya Morita ◽  
Maho Aoyama ◽  
Yoshiyuki Kizawa ◽  
...  
Keyword(s):  
Young Adult ◽  
Family Members ◽  
Adult Patients ◽  
Good Death ◽  
Patients With Cancer ◽  
Bereaved Family ◽  
Combined Data
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