title: Cancer patients' reluctance to disclose their emotional distress to their physicians: a study of Japanese patients with lung cancer.
abstract: OBJECTIVE
  To explore cancer patients' concerns about emotional disclosure (ED) to their physicians, and to investigate the factors associated with them.
  
  
  METHODS
  Randomly selected ambulatory patients with lung cancer participated in this study. An 18-item questionnaire to assess patients' beliefs regarding ED to their physicians was developed for this study. Factor analysis was used to extract the underlying factors of this scale. Patients were asked to answer this questionnaire along with other self-administered questionnaires.
  
  
  RESULTS
  Complete data were available from 104 patients. Four factors were extracted by factor analysis: 'Hesitation to disturb the physicians by ED', 'No perceived need for ED', 'Negative attitude towards ED', and 'Fear of a negative impact of ED'. All factors reached standards of internal consistency. The prevalence of the above concerns, in that order, among the patients was 68, 67, 46, and 20%. Patients with high distress levels were significantly more likely to endorse 'Negative impact' (p=0.02). Older patients were more likely to report 'Negative attitude' (p=0.06), whereas male patients were more likely than females to report 'Hesitation' (p=0.05).
  
  
  CONCLUSIONS
  Knowledge of such patient-related barriers should better prepare physicians to build good communication channels with their cancer patients.
authors.affiliation: Department of Psychiatry and Cognitive-behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. okuyama@med.nagoya-cu.ac.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Okuyama
authors.forename: Chiharu
authors.initials: C
authors.lastname: Endo
authors.forename: Takashi
authors.initials: T
authors.lastname: Seto
authors.forename: Masashi
authors.initials: M
authors.lastname: Kato
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Seki
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Akechi
authors.forename: Toshiaki A
authors.initials: TA
authors.lastname: Furukawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Eguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Hosaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D044466:Asian People / Q000523:psychology*; D003144:Communication Barriers; D003431:Cross-Cultural Comparison; D003469:Culture; D003863:Depression / Q000208:ethnology / Q000523:psychology; D003865:Major Depressive Disorder / Q000208:ethnology / Q000523:psychology; D004644:Emotions; D005260:Female; D005783:Gender Identity; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000208:ethnology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D010817:Physician-Patient Relations; D012650:Self Disclosure; D012803:Sick Role; D012945:Social Values; D011795:Surveys and Questionnaires