Healthcare Professionals' Perspectives on Revealing Truth about the Disease to Cancer Patients

Introduction: The process of revealing the truth and breaking bad news to cancer patients often causes stress and difficulties in the daily practice of healthcare professionals and seems to be influenced by several factors associated both with themselves and the patients. Purpose: The investigation of healthcare professionals' perspectives on revealing the truth to cancer patients about their disease. Material and Method: A cross sectional study was contacted from May 2016 to February 2017 in a sample of 79 healthcare professionals and senior students working or practicing in Oncology, Hematology and Surgical-Oncology departments of three major hospitals of Crete, Greece. Data were collected using an anonymous structured questionnaire and data analysis was conducted using IBM SPSS 23.0. Frequency distributions and 95% confidence intervals with bootstrap techniques were calculated while marginal homogeneity tests were used. Results: The majority of the participants were nurses (67.1%) working in hospital wards (74.7%). Most of them agreed to tell the truth from the time of diagnosis (88.3%, p<0.001) and mentioned that the patient should first be informed (40.3%). A physician along with a psychologist were considered as the most appropriate for the revealing process (44.9%). The main reasons reported for revealing the truth were the acceptance of the disease by the patient (69.3%) and his participation in the care plan (57.3%). On the contrary, as reasons for not revealing the truth, were an interdisciplinary instruction (33.0%) and the probability of an intense patient’s emotional response (26.3%). The young age of a patient in poor prognosis was reported as the main factor of difficulty in revealing the truth (p=0.004). Finally, half of the participants (50.6%) reported that they had not received any specific training, that they had difficulty dealing with cases with poor prognosis (68.8%, p<0.05) and that their appropriate training (42.6%) would make communication with their patients more effective. Conclusions: Healthcare professionals agree with revealing the truth about the disease to cancer patients, are aware of its benefits and consider that appropriate training could facilitate the process and could help improving the quality of patient care.