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Erschienen in: Supportive Care in Cancer 11/2016

14.06.2016 | Original Article

Exploring perceptions and preferences of patients, families, physicians, and nurses regarding cancer disclosure: a descriptive qualitative study

verfasst von: Parvaneh Abazari, Fariba Taleghani, Simin Hematti, Maryam Ehsani

Erschienen in: Supportive Care in Cancer | Ausgabe 11/2016

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Abstract

Purpose

The aim of this study was to explore perceptions and preferences of cancer patients, their families, physicians, and nurses in disclosing cancer diagnosis.

Methods

We selected 35 participants (15 patients, 6 family members, 9 physicians, and 5 nurses) by purposive sampling. We collected data by in-depth interviews and used qualitative content analysis for analysis.

Results

Data analysis resulted in three categories: (1) establishing a basis for breaking bad news; (2) adjusting to the tragedy of bad news; and (3) helping the patient cope with the shattering news. The first category comprised the following subcategories: provision of proper background; adhering to a patient-centered approach; and being unhurried. The second category comprised the following subcategories: cancer as a cultural taboo; death as a frightening vision of unattainable dreams and punishment; hope as an opening in the utter darkness of disease; and empathy as liniment for the injuries of disease. The third category comprised the following subcategories: the family as the most powerful healing source for the patient; the force of spirituality in achieving peace; and a multiprofessional, harmonious physician-centered team.

Conclusions

The findings of this study can help healthcare teams break the bad news of cancer diagnosis in a more effective, satisfactory, and culture-based manner for patients and their families.
Literatur
1.
Zurück zum Zitat Buckman R, Kason Y (1992) How to break bad news—a protocol for healthcare professionals. Toronto University Press, Toronto Buckman R, Kason Y (1992) How to break bad news—a protocol for healthcare professionals. Toronto University Press, Toronto
2.
Zurück zum Zitat Alrukban MO et al. (2014) Preferences and attitudes of the Saudi population toward receiving medical bad news: a primary study from Riyadh city. J Fam Community Med 21(2):85–92CrossRef Alrukban MO et al. (2014) Preferences and attitudes of the Saudi population toward receiving medical bad news: a primary study from Riyadh city. J Fam Community Med 21(2):85–92CrossRef
3.
Zurück zum Zitat Klocker-Kaiser U, Klocker J (2013) The setting, the truth, and the dimensions of communication with cancer patients. In: Surbone A et al. (eds) New challenges in communication with cancer patients. Springer, New York, pp. 231–234CrossRef Klocker-Kaiser U, Klocker J (2013) The setting, the truth, and the dimensions of communication with cancer patients. In: Surbone A et al. (eds) New challenges in communication with cancer patients. Springer, New York, pp. 231–234CrossRef
4.
Zurück zum Zitat Mazilu L et al. (2010) Ethical aspects of communication with cancer patients. Rom J Bioeth 8(3):181–188 Mazilu L et al. (2010) Ethical aspects of communication with cancer patients. Rom J Bioeth 8(3):181–188
5.
Zurück zum Zitat Seifart C et al. (2014) Breaking bad news—what patients want and what they get: evaluating the SPIKES protocol in Germany. Ann Oncol 25:707–711CrossRefPubMedPubMedCentral Seifart C et al. (2014) Breaking bad news—what patients want and what they get: evaluating the SPIKES protocol in Germany. Ann Oncol 25:707–711CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Schofield P et al. (2003) Psychological responses of patients receiving a diagnosis of cancer. Ann Oncol 14:48–56CrossRefPubMed Schofield P et al. (2003) Psychological responses of patients receiving a diagnosis of cancer. Ann Oncol 14:48–56CrossRefPubMed
8.
Zurück zum Zitat Clayton JM et al. (2007) Clinical practice guidelines for communicating prognosis and end-of-life issued with adults in the advanced stages of a life-limiting illness, and their caregivers. Med J Aust 186(12):s76–s108 Clayton JM et al. (2007) Clinical practice guidelines for communicating prognosis and end-of-life issued with adults in the advanced stages of a life-limiting illness, and their caregivers. Med J Aust 186(12):s76–s108
9.
Zurück zum Zitat Windwick, B., et al. (2011) Canadian disclosure guidelines: being open and honest with patients and families, C.P.S. Institute, Editor. Edmonton Windwick, B., et al. (2011) Canadian disclosure guidelines: being open and honest with patients and families, C.P.S. Institute, Editor. Edmonton
10.
Zurück zum Zitat Hollis R, Corkin D, Crawford D et al. (2013) Breaking bad news: supporting parents when they are told of their child’s diagnosis. London: Royal College of Nursing Hollis R, Corkin D, Crawford D et al. (2013) Breaking bad news: supporting parents when they are told of their child’s diagnosis. London: Royal College of Nursing
11.
Zurück zum Zitat Zahedi F (2011) The challenges of truth telling across cultures: a case study. J Med Ethics Hist Med 4(11):1–9 Zahedi F (2011) The challenges of truth telling across cultures: a case study. J Med Ethics Hist Med 4(11):1–9
12.
Zurück zum Zitat Kagawa-Singer M (2013) Teaching culturally component communication with diverse Ethnis patients and families. In: Surbone A et al. (eds) New challenges in communication with cancer patients. Springer, New York Kagawa-Singer M (2013) Teaching culturally component communication with diverse Ethnis patients and families. In: Surbone A et al. (eds) New challenges in communication with cancer patients. Springer, New York
13.
Zurück zum Zitat Labaf A, Jahanshir A, Baradaran H et al (2015) Is it appropriate to use Western guidelines for beaking bad news in non-Western emergency departments? A patients’ perspective. Clin Ethics 10(1–2):13–21 Labaf A, Jahanshir A, Baradaran H et al (2015) Is it appropriate to use Western guidelines for beaking bad news in non-Western emergency departments? A patients’ perspective. Clin Ethics 10(1–2):13–21
14.
Zurück zum Zitat Girgis A, Sanson-Fisher R, Schofield M (1999) Is there consensus between breast cancer patients and providers on guidelines for breaking bad news? Behav Med 25:69–77CrossRefPubMed Girgis A, Sanson-Fisher R, Schofield M (1999) Is there consensus between breast cancer patients and providers on guidelines for breaking bad news? Behav Med 25:69–77CrossRefPubMed
15.
Zurück zum Zitat Girgis A, Sanson-Fisher R, Schofield M (2010) Is there consensus between breast cancer patients and providers on guidelines on breaking bad news? Behav Med 25:69–77CrossRef Girgis A, Sanson-Fisher R, Schofield M (2010) Is there consensus between breast cancer patients and providers on guidelines on breaking bad news? Behav Med 25:69–77CrossRef
16.
Zurück zum Zitat Zamani A et al. (2011) Iranian physicians and patients attitude toward truth telling of cancer. J Isfahan Med Sch 29(143):752–760 Zamani A et al. (2011) Iranian physicians and patients attitude toward truth telling of cancer. J Isfahan Med Sch 29(143):752–760
17.
Zurück zum Zitat Lashkarizadeh M et al. (2012) Views of cancer patients on revealing diagnosis and information to them. Iran J Med Ethics Hist Med 5(4):65–75 Lashkarizadeh M et al. (2012) Views of cancer patients on revealing diagnosis and information to them. Iran J Med Ethics Hist Med 5(4):65–75
18.
Zurück zum Zitat Managheb SE, Hosseinpour M, Mehrabi F (2013) Patient’s viewpoints about how to break bad news. Iran J Med Ethics Hist Med 6(4):68–79 Managheb SE, Hosseinpour M, Mehrabi F (2013) Patient’s viewpoints about how to break bad news. Iran J Med Ethics Hist Med 6(4):68–79
19.
Zurück zum Zitat Arbabi M et al. (2010) How to break bad news: physicians’ and nurses’ attitutes. Iran J Psychiatry 5:128–133PubMedPubMedCentral Arbabi M et al. (2010) How to break bad news: physicians’ and nurses’ attitutes. Iran J Psychiatry 5:128–133PubMedPubMedCentral
20.
Zurück zum Zitat Munhall P (2007) Nursing Research, Fourth edn. JONES AND BARTLETT PUBLISHERS, Sudbury Munhall P (2007) Nursing Research, Fourth edn. JONES AND BARTLETT PUBLISHERS, Sudbury
21.
Zurück zum Zitat Sandelowski M (2000) Focus on research methods, what happened to qualitative description? Res Nurs Health 23:334–340CrossRefPubMed Sandelowski M (2000) Focus on research methods, what happened to qualitative description? Res Nurs Health 23:334–340CrossRefPubMed
22.
Zurück zum Zitat Streubert H, Carpenter D (2011) Qualitative research in nursing, Fifth edn. Lippincott willams wilkings, Philadelphia Streubert H, Carpenter D (2011) Qualitative research in nursing, Fifth edn. Lippincott willams wilkings, Philadelphia
23.
Zurück zum Zitat Graneheim U, Lundman B (2004) Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 24:105–112CrossRefPubMed Graneheim U, Lundman B (2004) Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 24:105–112CrossRefPubMed
24.
Zurück zum Zitat Guba EG (1981) Criteria for assessing the trustworthiness of naturalistic inquiries. ECTJ 29(2):75–91 Guba EG (1981) Criteria for assessing the trustworthiness of naturalistic inquiries. ECTJ 29(2):75–91
25.
Zurück zum Zitat Buckman RA (2005) Breaking bad news: the S-P-I-K-E-S strategy. Commun Oncol 2:138–142CrossRef Buckman RA (2005) Breaking bad news: the S-P-I-K-E-S strategy. Commun Oncol 2:138–142CrossRef
26.
Zurück zum Zitat Barclay JS, Blackhall L, Tulsky J (2007) Communication strategies and cultural issues in the delivery of bad news. J Palliat Med 10(4):958–977CrossRefPubMed Barclay JS, Blackhall L, Tulsky J (2007) Communication strategies and cultural issues in the delivery of bad news. J Palliat Med 10(4):958–977CrossRefPubMed
27.
Zurück zum Zitat Guerra-Tapia A, Gonzalez-Guerra E (2013) Communicating bad news during an office visit. Actas Dermosifiliogr 104(1):1–3CrossRefPubMed Guerra-Tapia A, Gonzalez-Guerra E (2013) Communicating bad news during an office visit. Actas Dermosifiliogr 104(1):1–3CrossRefPubMed
28.
Zurück zum Zitat Finn, G. and P. Costello (2010) Guidelines for communicating bad news with patients and their families, E.M.C. Network, Editor Finn, G. and P. Costello (2010) Guidelines for communicating bad news with patients and their families, E.M.C. Network, Editor
29.
Zurück zum Zitat Li J et al. (2012) Whether, when, and who to disclose bad news to patients with cancer: a survey in 150 pairs of hospitalized patients with cancer and family members in China. Psycho-Oncology 21:778–784CrossRefPubMed Li J et al. (2012) Whether, when, and who to disclose bad news to patients with cancer: a survey in 150 pairs of hospitalized patients with cancer and family members in China. Psycho-Oncology 21:778–784CrossRefPubMed
30.
Zurück zum Zitat Aljubran AH (2013) Challenges to the disclosure of bad news to cancer patients in the Middle East: Saudi Arabia as an example. In: Surbone A et al. (eds) New challenges in communication with cancer patients. Springer, New York Aljubran AH (2013) Challenges to the disclosure of bad news to cancer patients in the Middle East: Saudi Arabia as an example. In: Surbone A et al. (eds) New challenges in communication with cancer patients. Springer, New York
31.
Zurück zum Zitat Tsoussis S, Papadogiorgaki M, Markodimitraki E et al. (2013) Disclosure of cancer diagnosis: the Greek experience. JBUON 18(2):516–526 Tsoussis S, Papadogiorgaki M, Markodimitraki E et al. (2013) Disclosure of cancer diagnosis: the Greek experience. JBUON 18(2):516–526
32.
Zurück zum Zitat Bou Khalil R (2013) Attitudes, beliefs and perceptions regarding truth disclosure of cancer-related information in the Middle East: a review. Pallit Support Care 11(1):69–78CrossRef Bou Khalil R (2013) Attitudes, beliefs and perceptions regarding truth disclosure of cancer-related information in the Middle East: a review. Pallit Support Care 11(1):69–78CrossRef
34.
Zurück zum Zitat Zamanzadeh, V., et al. (2011) The taboo of cancer: the experiences of cancer disclosure by Iranian patients, their family members and Physicians. Psycho-Oncology Zamanzadeh, V., et al. (2011) The taboo of cancer: the experiences of cancer disclosure by Iranian patients, their family members and Physicians. Psycho-Oncology
35.
36.
Zurück zum Zitat Daher M (2012) Cultural beliefs and values in cancer patients. Ann Oncol 23(Supplement 3):iii66–iii69CrossRef Daher M (2012) Cultural beliefs and values in cancer patients. Ann Oncol 23(Supplement 3):iii66–iii69CrossRef
37.
Zurück zum Zitat Sweeny K, Shepperd JA (2007) Being the best bearer of bad tidings. Rev Gen Psychol 11(3):235–257CrossRef Sweeny K, Shepperd JA (2007) Being the best bearer of bad tidings. Rev Gen Psychol 11(3):235–257CrossRef
38.
Zurück zum Zitat Baile WF et al. (2000) SPIKES—a six-step protocol for delivering bad news: application to the patients with cancer. Oncologist 5:302–311CrossRefPubMed Baile WF et al. (2000) SPIKES—a six-step protocol for delivering bad news: application to the patients with cancer. Oncologist 5:302–311CrossRefPubMed
39.
Zurück zum Zitat Jalali M, Nasiri A, Abedi H (2014) Patients and family members’ experience regarding receiving bad news from health providers. Iran J Med Ethics Hist Med 7(5):83–93 Jalali M, Nasiri A, Abedi H (2014) Patients and family members’ experience regarding receiving bad news from health providers. Iran J Med Ethics Hist Med 7(5):83–93
40.
Zurück zum Zitat Zahedi F, Larijani B (2010) Truth telling across cultures: Islamic perspectives. Iran J Med Ethics Hist Med 3:1–11 Zahedi F, Larijani B (2010) Truth telling across cultures: Islamic perspectives. Iran J Med Ethics Hist Med 3:1–11
41.
Zurück zum Zitat Lim J, Yi J (2009) The effect of religiosity, spirituality and social support on quality of life: a comparison between Korean American and Korean breast and gynecological cancer survivors. Oncol Nurs Forum 36(6):699–708CrossRefPubMed Lim J, Yi J (2009) The effect of religiosity, spirituality and social support on quality of life: a comparison between Korean American and Korean breast and gynecological cancer survivors. Oncol Nurs Forum 36(6):699–708CrossRefPubMed
42.
Zurück zum Zitat Norris L, Walseman K, Puchalski CM (2013) Communicating about spiritual issues with cancer patients. In: Surbone A et al. (eds) New challenges in communication with cancer patients. Springer, New York, pp. 91–103CrossRef Norris L, Walseman K, Puchalski CM (2013) Communicating about spiritual issues with cancer patients. In: Surbone A et al. (eds) New challenges in communication with cancer patients. Springer, New York, pp. 91–103CrossRef
43.
Zurück zum Zitat Salem A, Salem A-F (2013) Breaking bad news: current prospective and practical guideline for Muslim countries. J Cancer Educ 28:790–794CrossRefPubMed Salem A, Salem A-F (2013) Breaking bad news: current prospective and practical guideline for Muslim countries. J Cancer Educ 28:790–794CrossRefPubMed
44.
Zurück zum Zitat Ibn Babawayh, M.I.A., Sawab-ul-Amal Aqaab-ul-Amal. 381 AH, Tehran: Sadoogh Publication. Ibn Babawayh, M.I.A., Sawab-ul-Amal Aqaab-ul-Amal. 381 AH, Tehran: Sadoogh Publication.
45.
Zurück zum Zitat Stiefel F, Krenz S (2013) Psychological challenges for the oncology clinician who has to break bad news. In: Surbone A et al. (eds) New challenges in communication with cancer patients. Springer, New York Stiefel F, Krenz S (2013) Psychological challenges for the oncology clinician who has to break bad news. In: Surbone A et al. (eds) New challenges in communication with cancer patients. Springer, New York
Metadaten
Titel
Exploring perceptions and preferences of patients, families, physicians, and nurses regarding cancer disclosure: a descriptive qualitative study
verfasst von
Parvaneh Abazari
Fariba Taleghani
Simin Hematti
Maryam Ehsani
Publikationsdatum
14.06.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 11/2016
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3308-x

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