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Breaking bad news to cancer patients in palliative care: A comparison of national cross-sectional surveys from 2006 and 2012

Published online by Cambridge University Press:  16 April 2015

Kanako Ichikura ,
Ayako Matsuda ,
Mika Kobayashi ,
Wataru Noguchi ,
Toshiko Matsushita  and
Eisuke Matsushima
Kanako Ichikura
Affiliation:
Section of Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
Ayako Matsuda
Affiliation:
Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
Mika Kobayashi
Affiliation:
Education and Research Support Center, Toho University, Tokyo, Japan
Wataru Noguchi
Affiliation:
Graduate School of Media andn Governance, Keio University, Kanagawa, Japan
Toshiko Matsushita
Affiliation:
Department of Nursing, Graduate School of Medicine, Yokohama City University, Kanagawa, Japan
Eisuke Matsushima*
Affiliation:
Section of Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
*
Address correspondence and reprint requests to: Eisuke Matsushima, Section of Liaison Psychiatry and Palliative Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. E-Mail: em.lppm@tmd.ac.jp
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Abstract

Objective:

Most cancer patients experience the time when a doctor must “break the bad news” to them, a time when it is necessary for patients to call upon their self-determination to aid in the battle with cancer. The purpose of our study was to clarify the percentage of times doctors deliver bad news to patients at the end of life in each of four different situations, and to define the most common recipients of this bad news. We compare these results for two timepoints: 2006 and 2012.

Methods:

The study had a national cross-sectional design consisting of self-completed questionnaires sent to all hospitals that provide cancer care. We mailed them to hospital directors in January and February of 2012, requesting a reply. The results of the same survey in 2006 were employed as a point for comparison.

Results:

A total of 1224 questionnaires were returned during 2012. 1499 responses collected in 2006 were employed as reference data. Some hospital characteristics had changed over that interval; however, the new data obtained were representative for patients being treated in Japanese cancer care hospitals. In hospitals with 300–499, there were significant differences between 2006 and 2012 in the providing information about (“disclosure of cancer diagnosis,” “therapeutic options for treatment,” and “a life-prolonging treatment”). In addition, the likelihood of doctors delivering bad news to patients and family members (as opposed to family members only) at the end of life increased from 2006 to 2012.

Significance of Results:

Our results suggest that the overall incidence of bad news being disclosed has increased, especially in hub medical institutions for cancer care. Advanced treatment options or domestic legislation may have influenced the frequency or type of bad news.

Keywords

Breaking bad newsTruth disclosurePalliative careEnd of lifeLife expectancy
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 6 , December 2015 , pp. 1623 - 1630
Copyright
Copyright © Cambridge University Press 2015 

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