A comparative investigation of clients' attitudes toward breaking bad news to patients with cancer

Background: Truth disclosure is one of the major challenges for physicians with cancer patients. The attitude toward breaking news adopted by individuals depends on their cultural background. The present study was conducted at Ardabil University of Medical sciences, Ardabil, Iran, to investigate the attitudes of Turkish-speaking patients with cancer and their families to the disclosure of bad news. Materials and Methods: The present descriptive cross-sectional study used convenience sampling to select 62 patients, 76 family members of young and 58 children. The mean age of the patients was 37.29 years, and their majorities were 32-42 years old. The data were collected using the questionnaire proposed by Managheb et al., which included six dimensions, i.e., suitability of the person, suitability of the time, the place, factors affecting the delivery of bad news, amount of disclosed information, and acceptance. Results: Despite the insignificant differences in the total score of attitude between the groups (P=0.23), significant differences were found in terms of suitability of the time (P=0.017) and affecting factors (P=0.007) between children's families. Also, in parents of children, employment made truth acceptance better (p=0.04). The acuteness of the disease increased the total attitude score in all the participants (P=0.047). Significant relationships were also observed between age and accepting truth (P=0.045), male gender and place of disclosing the truth (P=0.004), male gender and amount of disclosed information (P=0.043), as well as owning a house and accepting truth (P=0.002). Moreover, education was negatively related to the person for truth disclosing (P=0.036) and factors affecting the truth disclosing (P=0.015). Conclusion: There are different circumstances and economic impacts in children's families on their tolerance. Given the difficulty of disclosing the truth to the employee and highly-educated individuals, it is recommended that health workers consider individual conditions in these circumstances.

COVID-19 health policy evaluation: integrating health and economic perspectives with a data envelopment analysis approach

The COVID-19 pandemic is a global challenge to humankind. To improve the knowledge regarding relevant, efficient and effective COVID-19 measures in health policy, this paper applies a multi-criteria evaluation approach with population, health care, and economic datasets from 19 countries within the OECD. The comparative investigation was based on a Data Envelopment Analysis approach as an efficiency measurement method. Results indicate that on the one hand, factors like population size, population density, and country development stage, did not play a major role in successful pandemic management. On the other hand, pre-pandemic healthcare system policies were decisive. Healthcare systems with a primary care orientation and a high proportion of primary care doctors compared to specialists were found to be more efficient than systems with a medium level of resources that were partly financed through public funding and characterized by a high level of access regulation. Roughly two weeks after the introduction of ad hoc measures, e.g., lockdowns and quarantine policies, we did not observe a direct impact on country-level healthcare efficiency, while delayed lockdowns led to significantly lower efficiency levels during the first COVID-19 wave in 2020. From an economic perspective, strategies without general lockdowns were identified as a more efficient strategy than the full lockdown strategy. Additionally, governmental support of short-term work is promising. Improving the efficiency of COVID-19 countermeasures is crucial in saving as many lives as possible with limited resources.