The process of truth disclosure: an assessment of the results of information during the diagnostic phase in patients with cancer.
BACKGROUND
Surveys carried out in Mediterranean countries demonstrated very low rates of awareness of both diagnosis and prognosis among cancer patients. In our institution, a long-term training program aimed at improving communication skills among all physicians interacting with cancer patients was conducted. We report here the results of an extensive assessment of patients' awareness conducted after the first training period.


METHODS
In a 2-year period, after every first visit of patients with a histological diagnosis of cancer, oncologists elicited perception of the patients and completed a structured questionnaire focusing on the understanding of the diagnosis and prognosis. Our data are thus a photograph of the results of the informative process conducted during the diagnostic phase.


RESULTS
Among the enrolled 649 patients, 79.3% were aware of their diagnosis; factors significantly associated with higher levels of awareness were age younger than 70 and referral from surgery (versus internal medicine). Knowledge about the palliative or curative aims of future treatments (a surrogate sign of prognostic consciousness) was evident in 55.2%.


CONCLUSIONS
Compared with historical data, our results show a high level of comprehension of the diagnosis of malignancy, probably due to the extensive training effort together with the method chosen for assessment.
Numico
G
G
Medical Oncology Unit, Regional Hospital of the Aosta Valley, Aosta, Italy. gnumico@ausl.vda.it
Anfossi
M
M
Bertelli
G
G
Russi
E
E
Cento
G
G
Silvestris
N
N
Granetto
C
C
Di Costanzo
G
G
Occelli
M
M
Fea
E
E
Garrone
O
O
Gasco
M
M
Colantonio
I
I
Merlano
M
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001364:Awareness; D032882:Comprehension; D004645:Empathy; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000193:education*; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D010353:Patient Education as Topic; D028701:Patient Rights; D010817:Physician-Patient Relations; D011379:Prognosis; D015397:Program Evaluation; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D000078329:Workforce; D055815:Young Adult