This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Hancock, K. Articles by Tattersall, M. H. Search for Related Content PubMed PubMed Citation Articles by Hancock, K. Articles by Tattersall, M. H. Social Bookmarking                   What's this?

Truth-telling in discussing prognosis in advanced life-limiting illnesses: a systematic review

Medical Psychology Research Unit, University of Sydney, New South Wales

Josephine M Clayton

Medical Psychology Research Unit, University of Sydney, New South Wales and Department of Palliative Care, Royal North Shore Hospital, Sydney, jclayton{at}med.usyd.edu.au

Sharon M Parker

NHMRC Clinical Trials Centre, University of Sydney, New South Wales

Sharon Wal der

NHMRC Clinical Trials Centre, University of Sydney, New South Wales

Phyllis N Butow

Medical Psychology Research Unit and School of Psychology, University of Sydney, New South Wales

Sue Carrick

NHMRC Clinical Trials Centre, University of Sydney, New South Wales

David Currow

Palliative and Support Services, Flinders University, Adelaide

Davina Ghersi

NHMRC Clinical Trials Centre, University of Sydney, New South Wales

Paul Glare

Department of Palliative Care, Sydney Cancer Centre, Royal Prince Alfred Hospital, New South Wales

Rebecca Hagerty

Medical Psychology Research Unit and School of Psychology, University of Sydney, New South Wales

Martin HN Tattersall

Medical Psychology Research Unit and Department of Cancer Medicine, University of Sydney, New South Wales

Many health professionals (HPs) express discomfort at having to broach the topic of prognosis, including limited life expectancy, and may withhold information or not disclose prognosis. A systematic review was conducted of 46 studies relating to truth-telling in discussing prognosis with patients with progressive, advanced life-limiting illnesses and their caregivers. Relevant studies meeting the inclusion criteria were identified by searching computerized databases (MEDLINE, EMBASE, CINAHL, PsychINFO and Cochrane Register of Controlled Trials) up to November 2004, with handsearching of studies, as well as inclusion of studies satisfying selection criteria reported in 2005 by the authors. The reference lists of identified studies were hand-searched for further relevant studies. Inclusion criteria were studies of any design evaluating communication of prognostic information that included adult patients with an advanced, life-limiting illness; their caregivers; and qualified HPs. Results showed that although the majority of HPs believed that patients and caregivers should be told the truth about the prognosis, in practice, many either avoid discussing the topic or withhold information. Reasons include perceived lack of training, stress, no time to attend to the patient's emotional needs, fear of a negative impact on the patient, uncertainty about prognostication, requests from family members to withhold information and a feeling of inadequacy or hopelessness regarding the unavailability of further curative treatment. Studies suggest that patients can discuss the topic without it having a negative impact on them. Differences and similarities in findings from different cultures are explored. Palliative Medicine 2007; 21: 507—517

Key Words: communication • disclosure • end-of-life care • palliative care • prognosis • withholding information

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				A B Astrow, J R Sood, M T Nolan, P B Terry, L Clawson, J Kub, M Hughes, and D P Sulmasy Decision-making in patients with advanced cancer compared with amyotrophic lateral sclerosis J. Med. Ethics, September 1, 2008; 34(9): 664 - 668. [Abstract] [Full Text] [PDF]

				H. Dahlstrand, A. Hauksdottir, U. Valdimarsdottir, C.-J. Furst, K. Bergmark, and G. Steineck Disclosure of Incurable Illness to Spouses: Do They Want to Know? A Swedish Population-Based Follow-Up Study J. Clin. Oncol., July 10, 2008; 26(20): 3372 - 3379. [Abstract] [Full Text] [PDF]