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Experiences of truth disclosure in terminally ill cancer patients in palliative home care.

https://arctichealth.org/en/permalink/ahliterature259776
Source
Palliat Support Care. 2011 Jun;9(2):173-80
Publication Type
Article
Date
Jun-2011
Author
Maria Friedrichsen
Ann Lindholm
Anna Milberg
Source
Palliat Support Care. 2011 Jun;9(2):173-80
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Aged
Aged, 80 and over
Attitude to Death
Communication
Female
Home Care Services, Hospital-Based
Humans
Interviews as Topic
Male
Middle Aged
Palliative Care - organization & administration - psychology
Patient Preference - psychology
Physician-Patient Relations
Prognosis
Qualitative Research
Sweden
Terminally Ill - psychology
Truth Disclosure
Abstract
The aim of this study was to explore the experiences and preferences of terminally ill cancer patients regarding truth telling in the communication of poor prognoses.
We recorded and transcribed interviews with 45 patients who knew their cancer was terminal, and analyzed their responses hermeneutically.
Patients identified three different modes of truth: (1) the absolute objective truth that they are dying; (2) the partial truth about their condition including some facts but not all of the details; and (3) the desired truth, originating in the patient's own beliefs about a healthy or better life. Coping strategies were related to patients' preferred mode of truth: (1) facing the truth in order to take action; (2) facing some parts of the truth in order to maintain hope; and (3) hovering between facing and avoiding the truth. In their struggle for existential survival, patients used different coping strategies, changing from one to another depending upon the circumstances.
Varying use of different coping strategies impacts on patient preferences concerning communication about bad news with their doctors. Truth-telling entails more than merely providing information related to the forthcoming death. It also concerns how physicians or other healthcare staff can support the patient's existential survival by fine-tuning the communication of "truth" according to the individuals' preferences.
PubMed ID
24468485 View in PubMed
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