Breaking bad news - perceptions of cancer patients and their relatives

ABSTRACT

To study the perceptions of cancer patients and their relatives regarding disclosure of cancer related information. A cross sectional survey was conducted at Medical Oncology Ward, Hayatabad Medical Complex, Peshawar from September 2009 to January 2011. A total of 114 patients and their relatives were interviewed using a pre-designed questionnaire. Eighty Three [73%] were male while 31 [27%] were female. Median age of cancer patients was 36 [18-70] years. Forty-eight percent [29/60] cancer patients wished for full disclosure of bad news while 39% [21/54] of their relatives wanted full disclosure [p= Not Significant]. Sixty two percent [37/60] cancer patients and 74% [40/54] relatives wanted to be informed in case of recurrence [p= Not Significant]. Over 90% of patients and relatives wanted bad news to be broken by a senior consultant. Fifty eight percent [35/60] cancer patients and 52% [28/54] relatives wished for their relatives to make treatment decisions for them [p= Not Significant]. However, 93% [56/60] of cancer patients and 78% [42/54] of their relatives wanted full information about all side-effects of treatment [p < 0.02]. Fifty eight percent [35/60] cancer patients and 32% [17/54] relatives wanted their close relatives to be present while bad news was being broken [p<0.007]. Almost half of patients wished for full disclosure of information regarding cancer diagnosis. Over 90% patients wanted full information regarding all side-effects of chemotherapy. It is recommended that training regarding how to break bad news be made mandatory part of our medical training both at undergraduate and postgraduate levels