Differences between terminally ill patients who know, and those who do not know, that they are dying

Four GPs each selected 6 patients, 2 terminally ill with knowledge of diagnosis and prognosis, 2 terminally ill without knowledge, and 2 chronically ill. Semi-structured interviews were conducted with the patients, and the transcripts' content was analyzed. There were large group differences in the predicted direction in frequency of utterances that indicated knowledge, which both validated the content analysis and verified the GPs' capacity to categorize patients according to knowledge. Terminally ill patients with knowledge produced significantly longer transcripts than the other two groups. Groups did not differ significantly on state or trait anxiety scales. Differences due to demographic variables could not account for the main effects. There were significant associations that involved age, anxiety, and the dependent variables of the content analysis, especially among the terminally ill patients without knowledge.