Truth Telling in Cancer: the Difference between Patient Preference and Physician Practice (2~3 Years)

Truth telling in cancer is the conveyance of bad news. According literature review, there are cultural differences in the methods, attitude, and contents for truth telling internationally. Thus, the purpose of this study is to investigate the preferences of Taiwanese cancer patients in truth telling, and the difference between patients’ preferred truth-telling approaches and physician’s actual practice. In addition, the investigator is going to test the benefit of Standardized Communication Skill Training on competencies of truth telling for physicians. This research is a 3-year study, and invites subjects from various medical institutions of different levels in northern, central, and southern Taiwan. The subjects are the patients with six major cancers (e.g., lung cancer, colorectal cancer, oral cancer, liver cancer, breast cancer, and cervical cancer), their family members, and the attending physicians and nursing staffs. In order to collect data for this study, the methodological triangulation is used by combining both qualitative in-depth interview and quantitative questionnaires. The research focus of the first year is to investigate the perceptions and experiences of patients and their family members when being informed of the truth and the attending physician’s difficulty in telling the truth. After received grand from National Science Council, the investigator conducted one-on-one in-depth interview with 15 attending physicians. All interviews were taped recorded and transcribed verbatim. For qualitative inquiry, data collection and data analysis happened concurrently. To increase the credibility of the research, all data were analyzed by the principal investigator as well as two PhD students who had trained in qualitative research. The research focus of the second year is to investigate the difference between the preferences of cancer patients, their family members, physicians and nursing staffs on truth telling, as well as their actual clinical practice. The structured questionnaire (Japanese patients’ preferences questionnaire regarding the communication style of physicians delivering bad news about cancer) is used to collect the data. The research focus of the third year is to test the benefit of Standardized Communication Skill Training on competencies of truth telling for physicians. Experimental design is chosen to achieve the research purpose. The research results can be provided as references to the educational training for formal and in-service medical and nursing staff. Moreover, the research results can also decrease the emotional distress of cancer patients caused by inappropriate truth telling and increase working satisfaction for medical and nursing staffs.

Project ID:PF10107-1987
External Project ID:NSC101-2511-S182-002