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Attitudes, beliefs and perceptions regarding truth disclosure of cancer-related information in the Middle East: A review

Published online by Cambridge University Press:  22 November 2012

Rami Bou Khalil
Rami Bou Khalil*
Affiliation:
Psychiatric hospital of the Cross, Jalledib - Lebanon; Saint Joseph University, Beirut - Lebanon
*
Address correspondence and reprint requests to: Rami Bou Khalil, Psychiatric Hospital of the Cross-Jalledib-Lebanon, PO Box: 60096, Saint Joseph University, Beirut-Lebanon. E-mail: ramiboukhalil@hotmail.com
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Abstract

The aim of this review is to evaluate the current status concerning attitudes, beliefs and/or practices of patients, family members, health professionals and/or caregivers regarding truth disclosure about a cancer diagnosis in the Greater Middle East countries. A search was done via MedLine for all publications related to this review objective. 55 publications were included emanating from Egypt, Iran, Israel, Jordan, Kuwait, Lebanon, Palestine Pakistan, Saudi Arabia, Turkey, and United Arab Emirates. In the Greater Middle East region, a diagnosis of cancer is still mixed with social stigma and misperceptions related to incurability. Physicians conserve a truth disclosure policy in which from one side they respect some of the historical and cultural misperceptions about cancer and accordingly, tell the truth about cancer to one of the family members and from another side acknowledge the patients' right to know the truth and tend to disclose it for him(or her) when possible. Family members and caregivers' attitudes, perceptions and beliefs about telling the truth to the patient seem to be in favor of concealment. Discrepant results concerning physicians' and patients' evaluation of the quality of truth disclosure exist in the literature. Education programs in breaking bad news are lacking in many countries. Finally, the most important and common problem affecting truth disclosure to a patient suffering from cancer is the lack of codes and legislations concerning the patients' rights in an informed consent. Studies, legislations and training programs are needed in this domain in Middle Eastern societies.

Keywords

CancerTruth disclosureAttitudesBeliefsMiddle East
Type
Review Article
Information
Palliative & Supportive Care , Volume 11 , Issue 1 , February 2013 , pp. 69 - 78
Copyright
Copyright © Cambridge University Press 2012

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References

REFERENCES

Aaronson, N.K., Ahmedzai, S., Bergman, B., et al. (1993). The european organization for research and treatment of cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85, 365–376.Google Scholar
Abbas, S.Q., Muhammad, S.R., Mubeen, S.M., et al. (2004). Awareness of palliative medicine among Pakistani doctors: a survey. J Pak Med Assoc, 54, 195–199.Google ScholarPubMed
Abu-Saad Huijer, H. & Dimassi, H. (2007). Palliative care in Lebanon: knowledge, attitudes and practices of physicians and nurses. J Med Liban, 55, 121–128.Google Scholar
Adib, S.M. & Hamadeh, G.N. (1999). Attitudes of the Lebanese public regarding disclosure of serious illness. J Med Ethics, 25, 399–403.Google Scholar
Al-Abdi, S.Y., Al-Ali, E.A., Daheer, M.H., et al. (2011). Saudi mothers' preferences about breaking bad news concerning newborns: a structured verbal questionnaire. BMC Med Ethics, 12, 15.Google Scholar
Al-Amri, A.M. (2009). Cancer patients' desire for information: A study in a teaching hospital in Saudi Arabia. East Mediterr Health J, 15, 19–24.Google Scholar
Al-Amri, A.M. (2011). Attitudes of Saudi medical students toward the disclosure of information on cancer in eastern Saudi Arabia. J Family Community Med, 18, 54–58.Google Scholar
Aljubran, A.H. (2010). The attitude towards disclosure of bad news to cancer patients in Saudi Arabia. Ann Saudi Med, 30, 141–144.Google Scholar
Antoun, J. & Saab, B.R. (2010). A culturally sensitive audiovisual package to teach breaking bad news in a Lebanese setting. Med Teach, 32, 868–869.Google Scholar
Aoki, Y., Nakagawa, K., Hasezawa, K., et al. (1997). Significance of informed consent and truth-telling for quality of life in terminal cancer patients. Radiat Med, 15, 133–135.Google Scholar
Ateşci, F.C., Baltalarli, B., Oguzhanoglu, N.K., et al. (2004). Psychiatric morbidity among cancer patients and awareness of illness. Support Care Cancer, 12, 161–167.Google Scholar
Ateşci, F.C., Oğuzhanoğlu, N.K., Baltalarli, B., et al. (2003). Psychiatric disorders in cancer patients and associated factors. Turk Psikiyatri Derg, 14, 145–152.Google Scholar
Baider, L., Sarell, M. & Edelstein, E.L. (1982). Selected social-psychological characteristics of a sample of Israeli cancer patients: facts and implications. Isr J Med Sci, 18, 259–265.Google Scholar
Baider, L., Uziely, B. & De-Nour, A.K. (1997). The impact of perceived behavior on patient-physician satisfaction. Ann N Y Acad Sci, 809, 266–278.CrossRefGoogle ScholarPubMed
Banning, M., Hassan, M., Faisal, S., et al. (2010). Cultural interrelationships and the lived experience of Pakistani breast cancer patients. Eur J Oncol Nurs, 14, 304–309.Google Scholar
Beck, A.T., Ward, C.H., Mendelson, M., et al. (1961). An inventory for measuring depression. Arch Gen Psychiatry, 4, 561–571.Google Scholar
Ben Natan, M., Shahar, I. & Garfinkel, D. (2009). Disclosing bad news to patients with life-threatening illness: differences in attitude between physicians and nurses in Israel. Int J Palliat Nurs, 15, 276–281.Google Scholar
Bozcuk, H., Erdoğan, V., Eken, C., et al. (2002). Does awareness of diagnosis make any difference to quality of life? Determinants of emotional functioning in a group of cancer patients in Turkey. Support Care Cancer, 10, 51–57.Google Scholar
Bozo, O., Anahar, S., Ateş, G., et al. (2010). Effects of illness representation, perceived quality of information provided by the health-care professional, and perceived social support on depressive symptoms of the caregivers of children with leukemia. J Clin Psychol Med Settings, 17, 23–30.Google Scholar
Chan, D. & Loth, L.G. (2000). The doctor–patient relationship: a survey of attitudes and practices of doctors in Singapore. Bioethics, 14, 58–76.CrossRefGoogle ScholarPubMed
Charniot, J.C., Barthelemy, B., Zerhouni, K., et al. (2000). Patient information. First evaluation. Arch Mal Coeur Vaiss, 94, 962–966.Google Scholar
Chaitchik, S., Kreitler, S., Shaked, S., et al. (1992). Doctor-patient communication in a cancer ward. J Cancer Educ, 7, 41–54.CrossRefGoogle Scholar
Cohen Castel, O., Alperin, M., Ungar, L., et al. (2011). Urologists' attitudes regarding information sharing with prostate cancer patients–is there a common ground for collaboration with family physicians? J Cancer Educ, 26, 315–321.Google Scholar
Cohen Castel, O., Ungar, L., Alperin, M., et al. (2008). Family physicians' perceptions, beliefs, and attitudes regarding information sharing with prostate cancer patients throughout the course of the disease. Support Care Cancer, 16, 955–961.CrossRefGoogle ScholarPubMed
Dalla-Vorgia, P., Katsouyanni, K., Garanis, T.N., et al. (1992). Attitudes of a Mediterranean population to the truth-telling issue. J Med Ethics, 2, 67–74.CrossRefGoogle Scholar
Derman, U. & Serbest, P. (1993). Cancer patients' awareness of disease and satisfaction with services: The influence of their general education level. J Cancer Educ, 8, 141–144.CrossRefGoogle ScholarPubMed
Doumit, M.A. & Faire Face Group. (2011). Cancer patients support: the Lebanese experience. Psychooncology, 20, 443.Google Scholar
Doumit, M.A. & Abu-Saad, H.H. (2008). Lebanese cancer patients: Communication and truth telling preferences. Contemp Nurse, 28, 74–82.Google Scholar
Doumit, M.A., Abu-Saad Huijer, H. & Kelley, J.H. (2007). The lived experience of Lebanese oncology patients receiving palliative care. Eur J Oncol Nurs, 11, 309–319.Google Scholar
Doumit, M.A., El Saghir, N., Abu-Saad Huijer, H., et al. (2010). Living with breast cancer, a Lebanese experience. Eur J Oncol Nurs, 14, 42–48.CrossRefGoogle ScholarPubMed
El-Ghazali, S. (1997). Is it wise to tell the truth, the whole truth, and nothing but the truth to a cancer patient? Ann N Y Acad Sci, 809, 97–108.Google Scholar
Erer, S., Atici, E. & Erdemir, A.D. (2008). The views of cancer patients on patient rights in the context of information and autonomy. J Med Ethics, 34, 384–388.CrossRefGoogle ScholarPubMed
Espinosa, E., Gonzales Baron, M., Poveda, J., et al. (1993). The information given to the terminal patient with cancer. Eur J Cancer, 29, 1795–1796.CrossRefGoogle Scholar
Ghavamzadeh, A. & Bahar, B. (1997). Communication with the cancer patient in Iran. Information and truth. Ann N Y Acad Sci, 809, 261–265.CrossRefGoogle ScholarPubMed
Guven, T. (2010). Truth-telling in cancer: examining the cultural incompatibility argument in Turkey. Nurs Ethics, 17, 159–166.Google Scholar
Hamadeh, G.N. & Adib, S.M. (1998). Cancer truth disclosure by Lebanese doctors. Soc Sci Med47, 1289–1294.Google Scholar
Hamadeh, G.N. & Adib, S.M. (2001). Changes in attitudes regarding cancer disclosure among medical students at the American University of Beirut. J Med Ethics, 27, 354.Google ScholarPubMed
Harrison, A., al-Saadi, A.M.H., al-Kaabi, A.S.O., et al. (1997). Should doctors inform terminally ill patients? The opinions of nationals and doctors in the United Arab Emirates. J Med Ethics, 23, 101–107.Google Scholar
Ibrahim, E.M., Al-Muhanna, F.A., Saied, I., et al. (1991). Public knowledge, misperceptions, and attitudes about cancer in Saudi Arabia. Ann Saudi Med, 11, 518–523.Google Scholar
Ishaque, S., Saleem, T., Khawaja, F.B., et al. (2010). Breaking bad news: exploring patient's perspective and expectations. J Pak Med Assoc, 60, 407–411.Google Scholar
Lebanese Code of Medical Ethics. (1995). Decree 24. Official Gazette, May.Google Scholar
Malik, I.A. & Qureshi, A.F. (1997). Communication with cancer patients. Experiences in Pakistan. Ann N Y Acad Sci, 809, 300–308.CrossRefGoogle ScholarPubMed
Meitar, D., Karnieli-Miller, O. & Eidelman, S. (2009). The impact of senior medical students' personal difficulties on their communication patterns in breaking bad news. Acad Med, 84, 1582–1594.Google Scholar
Mobeireek, A.F., al-Kassimi, F.A., al-Majid, S.A., et al. (1996). Communication with the seriously ill: physicians' attitudes in Saudi Arabia. J Med Ethics, 22, 282–285.Google Scholar
Mobeireek, A.F., Al-Kassimi, F., Al-Zahrani, K., et al. (2008). Information disclosure and decision-making: The Middle East versus the Far East and the West. J Med Ethics, 34, 225–229.CrossRefGoogle ScholarPubMed
Montazeri, A., Tavoli, A., Mohagheghi, M.A., et al. (2009). Disclosure of cancer diagnosis and quality of life in cancer patients: should it be the same everywhere? BMC Cancer, 9, 39.CrossRefGoogle ScholarPubMed
Montazeri, A., Vahdani, M., Haji-Mahmoodi, M., et al. (2002). Cancer patient education in Iran: A descriptive study. Support Care Cancer, 10, 169–173.Google Scholar
Mystadikou, K., Liossi, C., Valchos, L., et al. (1996). Disclosure of diagnostic information to cancer patients in Greece. Palliat Med, 10, 195–200.Google Scholar
Novack, D.H., Plumer, R., Smith, R.L., et al. (1979). Changes in physicians attitudes toward telling the cancer patient. JAMA, 241, 897–900.CrossRefGoogle ScholarPubMed
Oken, D. (1961). What to tell cancer patients. A study of medical attitudes. JAMA, 175, 1120–1128.CrossRefGoogle ScholarPubMed
Oksüzoğlu, B., Abali, H., Bakar, M., et al. (2006). Disclosure of cancer diagnosis to patients and their relatives in Turkey: views of accompanying persons and influential factors in reaching those views. Tumori, 92, 62–66.CrossRefGoogle ScholarPubMed
Ozdogan, M., Samur, M., Artac, M., et al. (2006). Factors related to truth-telling practice of physicians treating patients with cancer in Turkey. J Palliat Med, 9, 1114–1119.Google Scholar
Ozdogan, M., Samur, M., Bozcuk, H.S., et al. (2004). “Do not tell”: What factors affect relatives' attitudes to honest disclosure of diagnosis to cancer patients? Support Care Cancer, 12, 497–502.Google Scholar
Pellegrino, E.D. (1992). Is truth telling to patients a cultural artifact? JAMA, 268, 1734–1735.CrossRefGoogle ScholarPubMed
Prohaska, T.R., Leventhal, E.A., Leventhal, H., et al. (1985). Health practices and illness cognition in young, middle aged and elderly adults. J Gerontol, 40, 569–578.Google Scholar
Qaddoumi, I., Ezam, N., Swaidan, M., et al. (2009). Diffuse pontine glioma in Jordan and impact of up-front prognosis disclosure with parents and families. J Child Neurol, 24, 460–465.Google Scholar
Qasem, A.A., Ashour, T.H., Al-Abdulrazzaq, et al. (2002). Disclosure of cancer diagnosis and prognosis by physicians in Kuwait. Int J Clin Pract, 56, 215–218.Google Scholar
Rassin, M., Levy, O., Schwartz, T., et al. (2006). Caregivers' role in breaking bad news: patients, doctors, and nurses' points of view. Cancer Nurs, 29, 302–308.CrossRefGoogle ScholarPubMed
Republic of Lebanon. (2004). Law No. 574 on patients rights and informed consent. Official GazetteFebruary.Google Scholar
Sapir, R., Catane, R., Kaufman, B., et al. (2000). Cancer patient expectations of and communication with oncologists and oncology nurses: The experience of an integrated oncology and palliative care service. Support Care Cancer, 8, 458–463.CrossRefGoogle ScholarPubMed
Sardell, A.N. & Trierweiler, S.J. (1993). Disclosing the cancer diagnosis. Procedures that influence patient hopefulness. Cancer, 72, 3355–3365.Google Scholar
Schattner, A. & Tal, M. (2002). Truth telling and patient autonomy: The patient's point of view. Am J Med, 113, 66–69.Google Scholar
Sen, M. (1997). Communication with cancer patients. The influence of age, gender, education, and health insurance status. Ann N Y Acad Sci, 809, 514–524.Google Scholar
Surbone, A. & Zwitter, M. (1997). Learning from the world. The editors' perspective. Ann N Y Acad Sci, 809, 1–6.CrossRefGoogle ScholarPubMed
Tanida, N. (1994). Japanese attitudes toward truth disclosure in cancer. Scand J Soc Med 22: 50–57.Google Scholar
Tavoli, A., Mohagheghi, M.A., Montazeri, A., et al. (2007). Anxiety and depression in patients with gastrointestinal cancer: Does knowledge of cancer diagnosis matter? BMC Gastroenterol, 7, 28.CrossRefGoogle ScholarPubMed
Tavakol, M., Murphy, R. & Torabi, S. (2008). Educating doctors about breaking bad news: An Iranian perspective. J Cancer Educ, 23, 260–263.CrossRefGoogle ScholarPubMed
Tavakol, M., Torabi, S., Lyne, O.D., et al. (2005). A quantitative survey of intern's knowledge of communication skills: an Iranian exploration. BMC Med Educ, 5, 6.CrossRefGoogle ScholarPubMed
Ungar, L., Alperin, M., Amiel, G.E., et al. (2002). Breaking bad news: structured training for family medicine residents. Patient Educ Couns, 48, 63–68.Google Scholar
Vincent, J.L. (1998). Information in the ICU: Are we being honest with our patients? The results of a European questionnaire. Intensive Care Med, 24, 1251–1256.CrossRefGoogle Scholar
Weil, M., Smith, M. & Khayat, D. (1994). Truth-telling to cancer patients in the western European context. Psychooncology, 3, 21–26.Google Scholar
Williams, C.J. & Zwitter, M. (1994). Informed consent in European multicenter randomized clinical trials-are patients really informed? Eur J Cancer, 30, 907–910.CrossRefGoogle Scholar
Yildirim, T. & Erişen, L. (2008). Disclosure of the diagnosis to the patient with head and neck cancer. Kulak Burun Bogaz Ihtis Derg, 18, 273–279.Google Scholar
Younge, D., Moreau, P., Ezzat, A., et al. (1997). Communicating with cancer patients in Saudi Arabia. Ann N Y Acad Sci, 809, 309–316.Google Scholar
Zimet, G.D., Powell, S.S., Farley, G.K., et al. (1990). Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. J Pers Assess, 55, 610–617.CrossRefGoogle ScholarPubMed