title: If you had less than a year to live, would you want to know? A seven-country European population survey of public preferences for disclosure of poor prognosis.
abstract: OBJECTIVE
  With increasing European cancer deaths, clinicians must manage information regarding poor prognosis. This study aimed to determine European citizens' preferences, within a scenario of serious illness such as cancer with less than a year to live, for information disclosure regarding poor prognosis, the likely symptoms and problems, and the care options available, to measure variations between countries and to identify factors associated with preferences.
  
  
  METHODS
  A population-based cross-national telephone survey using random digit dialling in seven countries was conducted.
  
  
  RESULTS
  Among 9344 respondents, data revealed an international preference (73.9%) to always be informed in the scenario of having a serious illness such as cancer with less than a year to live. This varied from 67.6% in Italy to 80.7% in Flanders. A minority (21.1%) did not want such information unless they ask, or at all. People younger than 70 years (OR 0.72, 95% CI 0.62-0.83, p < 0.001), men (OR 1.23, 95% CI 1.10-1.37, p < 0.001), those with experience of illness (OR = 1.20. 95% CI 1.01-1.43, p < 0.05) and with more education (OR = 1.20, 95% CI 1.09-1.32, p < 0.001) were more likely to want to know of limited time left.
  
  
  CONCLUSIONS
  The models confirmed the influence of four factors in more than one country (age, gender, education and most concerning problem) and added 11 country-specific factors to which national policies and clinical practice should respond. These findings confirm a majority public preference to be informed in a scenario of poor prognosis. Policy clinical practice should facilitate elucidation and delivery of preferences. Evidence for effective communication skills-building interventions for clinicians is required.
authors.affiliation: King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, SE5 9PJ, UK.
authors.forename: R
authors.initials: R
authors.lastname: Harding
authors.affiliation: King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, SE5 9PJ, UK.|London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: V
authors.initials: V
authors.lastname: Simms
authors.affiliation: King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, SE5 9PJ, UK.
authors.forename: N
authors.initials: N
authors.lastname: Calanzani
authors.affiliation: King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, SE5 9PJ, UK.
authors.forename: I J
authors.initials: IJ
authors.lastname: Higginson
authors.affiliation: King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, SE5 9PJ, UK.
authors.forename: S
authors.initials: S
authors.lastname: Hall
authors.affiliation: Barcelona Centre for International Health Research (CRESIB - Hospital Clínic), Universitat de Barcelona, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Gysels
authors.affiliation: Barcelona Centre for International Health Research (CRESIB - Hospital Clínic), Universitat de Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Meñaca
authors.affiliation: King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, SE5 9PJ, UK.|Deutsche Gesellschaft für Palliativmedizin, Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Bausewein
authors.affiliation: End-of-Life Care Research Group, Ghent University & Vrije Universiteit Brussel, Brussels, Belgium.|Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Palliative Care Center of Expertise, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Deliens
authors.affiliation: Centre for Health Studies and Research, University of Coimbra (CEISUC), Coimbra, Portugal.
authors.forename: P
authors.initials: P
authors.lastname: Ferreira
authors.affiliation: Istituto di Ricerca in Medicina Palliativa, Fondazione Lino Maestroni - ONLUS, Cremona, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Toscani
authors.affiliation: King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, SE5 9PJ, UK.
authors.forename: B A
authors.initials: BA
authors.lastname: Daveson
authors.affiliation: University of Antwerp, Antwerp, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Ceulemans
authors.affiliation: King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, London, SE5 9PJ, UK.
authors.forename: B
authors.initials: B
authors.lastname: Gomes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001293:Attitude to Death; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D057240:Patient Preference / Q000523:psychology*; D011639:Public Opinion; D019452:Terminally Ill / Q000523:psychology*; D014342:Truth Disclosure; D055815:Young Adult
keywords: Europe; cancer; information; oncology; preferences; prognosis