Disclosure preferences towards terminally ill patients in Singapore: are we ready to confront the "elephant in the room"

Lee, Soak-Mun, and Hawkins, Russell (2015) Disclosure preferences towards terminally ill patients in Singapore: are we ready to confront the "elephant in the room". Austral-Asian Journal of Cancer, 14 (1). pp. 9-17.

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The disclosure preferences of dying patients, family members, palliative care professionals and members of the public in Singapore and the actual disclosure practices of palliative care professionals were investigated with 115 participants. Discrepancies between patient and family member preferences were evident. Family members tended to want to know the patients' diagnosis and prognosis more than the patients themselves wished for the family to be informed. Family members also wanted patients to be informed of their diagnosis and prognosis even though they believed that the patients sometimes preferred otherwise. In the situation where family members were asked about their own disclosure preferences should they have a terminal illness, more preferred full disclosure of prognosis to self than to their family. The finding that people imagining a terminal illness reported wanting to know their own (hypothetical) diagnosis and prognosis more frequently than actual patients do is a salient reminder about the danger of making assumptions about patient preferences. Concerns reported by palliative care professionals showed that they are careful about the potential impact their disclosure may have on patients. Palliative care professionals nonetheless did tend to respect family member wishes over those of the patients. They perceived their lack of communication skills in delivering bad news as the main barrier to open communication. The allied healthcare participants in this study appeared to be more confident in communicating bad news than the doctors and nurses, but their expertise did not seem to be fully utilised. Thus, there may be some potential for closer collaboration and cross training amongst the professions to increase self-efficacy in delivering bad news.

Item ID: 40677
Item Type: Article (Research - C1)
ISSN: 0972-2556
Keywords: cancer; disclosure; diagnosis; prognosis; Singapore
Date Deposited: 01 Oct 2015 01:08
FoR Codes: 17 PSYCHOLOGY AND COGNITIVE SCIENCES > 1701 Psychology > 170106 Health, Clinical and Counselling Psychology @ 100%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920211 Palliative Care @ 100%
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