Defining diagnostic disclosure in the acute care setting: A concept analysis

Patients are often unaware of their medical diagnoses, impeding their ability to effectively self-manage their conditions. Diagnostic disclosure, the act of clinicians making diagnoses known to patients, can enhance patient awareness, understanding, and adherence to recommended treatments and care plans. Published literature about diagnostic disclosure is limited to dementia, autism, and cancer, and although diagnostic disclosure commonly occurs during hospitalization, what it entails is rarely considered in the acute care setting. Developing a clear definition of diagnostic disclosure in acute care is essential to understand its potential impact.

Develop conceptual and operational definitions of diagnostic disclosure in the acute care setting.

The Walker and Avant eight-step approach to concept analysis was employed to identify defining attributes, antecedents, and consequences of diagnostic disclosure in the acute care setting. Four databases (PubMed, CINAHL, Scopus, EMBASE) were searched using keywords and controlled vocabulary to identify studies related to diagnostic disclosure among adult populations in the acute care setting. This search yielded 2052 unique articles, of which 37 (published between 1994 and 2025) met inclusion criteria.

No articles that used the term "diagnostic disclosure" provided a definition. Therefore, two defining attributes, The Disclosure Process and Diagnostic Content, identified in the literature guided the development of conceptual and operational definitions. Diagnostic disclosure is defined as the process through which a clinician names and explains a patient's diagnosis. Diagnostic disclosure can be measured by the "fullness" of the diagnostic content disclosed. For example, "full" diagnostic disclosure involves both naming and explaining the diagnosis, whereas partial disclosure may either name or euphemistically explain the diagnosis. Model, Borderline, Related, and Contrary Cases further circumscribe the concept. Antecedents included Clinician Attitudes and Beliefs, Clinician Skill, Patient Characteristics, Patient Curiosity, Characteristics of the Diagnosis, Cultural Context, Family Consent, Environment, and The Diagnostic Process. Consequences included The Patient's Right, Information-Seeking Patients, Shared Decision-Making, Grief and Coping, Disease Adaptation, Strengthened Relationships, Adherence and Self-Care, and Well-Being and Quality of Life.

The definitions provided advance our understanding of diagnostic disclosure with implications for practice and future research. A clearly defined concept sets the foundation to measure, predict, and investigate diagnostic disclosure further. This analysis identifies diagnostic disclosure as critical to patient-centered care, with potential to improve communication, enhance self-care, and prevent rehospitalization. Future efforts should focus on testing the operational definition, evaluating effects on patient outcomes, and surveying patients, caregivers, and clinicians to inform clinical integration.