ABCDE assessment for palliative care truth-telling dilemmas: a case study

Area of Science:

• Medical Ethics
• Cross-Cultural Healthcare
• Palliative Care Communication

Background:

• Family involvement is central to Indonesian culture, influencing healthcare decisions and patient care.
• The diagnosis of serious illness in Indonesia is often communicated through the family unit.

Purpose of the Study:

• To illustrate the challenges healthcare professionals encounter when disclosing serious diagnoses to patients in Indonesia.
• To examine the role of family in truth-telling dilemmas within the Indonesian healthcare context.

Main Methods:

• A case study approach was employed to explore truth-telling scenarios.
• The Kagawa-Singer and Blackhall ABCDE framework was utilized to assess patient and family dynamics.
• The framework evaluated attitudes (A), beliefs (B), contexts (C), decision-making styles (D), and environments (E).

Main Results:

• Family participation in health communication can reduce patient stress during serious illness disclosure.
• Integrating the ABCDE model into palliative care facilitates family involvement in diagnosis and disease trajectory discussions.
• Acknowledging cultural contexts is vital for effective patient-family communication in serious illness.

Conclusions:

• Palliative care nurses must recognize and incorporate the cultural significance of family in Indonesia.
• Utilizing a structured framework like ABCDE enhances the integration of family in sensitive medical communications.
• Effective truth-telling in Indonesia necessitates a family-centered approach within palliative care settings.