Predicaments and coping strategies in implementing cancer truth-telling: a qualitative content analysis

Area of Science:

• Oncology
• Medical Ethics
• Cross-cultural Healthcare Communication

Background:

• Western patient-centered communication contrasts with Eastern family-centered decision-making.
• Attending physicians' challenges and coping mechanisms in cancer truth-telling remain underexplored in Taiwan.

Purpose of the Study:

• To investigate the predicaments encountered by attending physicians in Taiwan when disclosing cancer diagnoses.
• To identify the coping strategies employed by these physicians during the truth-telling process.

Main Methods:

• Qualitative description approach utilizing in-depth, semi-structured interviews.
• 17 attending physicians from two Taiwanese medical centers were purposively sampled.
• Inductive content analysis was applied to interview transcripts.

Main Results:

• Physicians face dilemmas regarding potential harm to patients and the necessity of family cooperation.
• Requests from family members to conceal the truth present challenges, requiring physicians to assess the patient's condition.
• Strategies include prioritizing patient confidence and managing delayed treatment, with varied approaches for delivering news of relapse.

Conclusions:

• Taiwanese physicians often prioritize family-centered care, even when it conflicts with patient-centered principles.
• Physicians frequently cooperate with families to determine the extent and method of truth disclosure.
• Emphasis is placed on addressing patients' psychological needs during relapse, metastasis, or significant emotional distress.