Objective: Employing a nationwide cross-sectional survey, we
investigated the Japanese general population's attitudes toward
disease and prognosis disclosure and related factors. Furthermore, we
investigated Japanese medical practitioners' attitudes toward disease
and prognosis disclosure for patients and decision making.
Methods: A nationwide anonymous questionnaire survey was
conducted. A total of 5000 individuals were randomly sampled from the
general population and 3104 physicians and 6059 nurses were randomly
sampled in Japan.
Results: Finally, 2422 people from the general population
(response rate, 48%), 1577 physicians (51%), and 3361 nurses (56%)
returned questionnaires. Among the general population, 73% of participants
answered that they “want to know” about their disease and
prognosis when in an incurable disease state. Ninety percent desired
direct disclosure and 8% disclosure through their family. However, few
medical practitioners answered “patient himself” (physician
3%, nurses 4%) as the person whom they would primarily notify about the
disease and prognosis when in charge of a patient with an incurable
disease. On the other hand, physicians answered “family” most
frequently (59%), whereas nurses most commonly responded, “depends
on patient's condition” (63%).
Significance of research: Several detailed analyses of
factors associated with prognosis disclosure were conducted. Japanese
physicians need to carefully communicate with the patients individually
about whether direct disclosure or disclosure primarily to the family is
preferred.