title: Attitudes toward disease and prognosis disclosure and decision making for terminally ill patients in Japan, based on a nationwide random sampling survey of the general population and medical practitioners.
abstract: OBJECTIVE
  Employing a nationwide cross-sectional survey, we investigated the Japanese general population's attitudes toward disease and prognosis disclosure and related factors. Furthermore, we investigated Japanese medical practitioners' attitudes toward disease and prognosis disclosure for patients and decision making.
  
  
  METHODS
  A nationwide anonymous questionnaire survey was conducted. A total of 5000 individuals were randomly sampled from the general population and 3104 physicians and 6059 nurses were randomly sampled in Japan.
  
  
  RESULTS
  Finally, 2422 people from the general population (response rate, 48%), 1577 physicians (51%), and 3361 nurses (56%) returned questionnaires. Among the general population, 73% of participants answered that they "want to know" about their disease and prognosis when in an incurable disease state. Ninety percent desired direct disclosure and 8% disclosure through their family. However, few medical practitioners answered "patient himself" (physician 3%, nurses 4%) as the person whom they would primarily notify about the disease and prognosis when in charge of a patient with an incurable disease. On the other hand, physicians answered "family" most frequently (59%), whereas nurses most commonly responded, "depends on patient's condition" (63%).
  
  
  CONCLUSIONS
  Several detailed analyses of factors associated with prognosis disclosure were conducted. Japanese physicians need to carefully communicate with the patients individually about whether direct disclosure or disclosure primarily to the family is preferred.
authors.affiliation: Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-0033, Japan. miyasita-tky@umin.net
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Miyashita
authors.forename: Shuji
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Masako
authors.initials: M
authors.lastname: Kawa
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Shima
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kawagoe
authors.forename: Tsuneto
authors.initials: T
authors.lastname: Hase
authors.forename: Yae
authors.initials: Y
authors.lastname: Shinjo
authors.forename: Keiichi
authors.initials: K
authors.lastname: Suemasu
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003142:Communication; D003430:Cross-Sectional Studies; D003625:Data Collection; D003627:Data Interpretation, Statistical; D003657:Decision Making; D005190:Family; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D010819:Physician's Role; D010817:Physician-Patient Relations; D011379:Prognosis; D012494:Sampling Studies; D011795:Surveys and Questionnaires; D019452:Terminally Ill; D014342:Truth Disclosure