title: Does the Approach of Disclosing More Detailed Information of Cancer for the Terminally Ill Patients Improve the Quality of Communication Involving Patients, Families, and Medical Professionals?
abstract: OBJECTIVE
  Effective and faithful communication between patients and medical professionals could improve patients' quality of life and is an essential and fundamental factor in cancer treatment. The purpose of this study was to examine whether disclosing more detailed information about disease progression toterminally ill patients could improve the quality of communication.
  
  
  METHODS
  This was a before/after study of 91 consecutive terminal cancer patients. Based on the previous studies, we categorized cancer disclosure into 4 groups: A;"non-disclosure", B;"disclosure of cancer diagnosis", C;"disclosureof life-threatening disease", and D;"disclosure of poor prognosis". We disclosed more detailed information based on the SPIKES protocol and compared the scores of 3 communication items of Support Team Assessment Schedule (Japanese version) measured between at admission and one-week after this approach.
  
  
  RESULTS
  A, B, C and D groups included 8, 25, 40, and 18 cases, respectively. This approach to cancer disclosure was implemented in 37.5% of group A, 60% of group B, and 40% of group C. In group B, all 3 communications were significantly improved (2.40 ± 0.51 vs 1.53 ± 0.83, 1.93 ± 0.96 vs 1.00 ± 0.38, 2.13 ± 0.64 vs 1.13 ± 0.64; p = 0.0035, 0.0062, 0.0013). In group C, all 3 communications were significantly improved (1.25 ± 0.58 vs 0.81 ± 0.66, 1.13 ± 0.34 vs 0.69 ± 0.48, 1.31±0.60 vs 0.56 ± 0.63; p = 0.020, 0.0082, 0.0057).
  
  
  CONCLUSIONS
  This study revealed that disclosing more detailed information of cancer for terminally ill cancer patients contributed to improving the quality of communication, irrespective of the stage of disclosure.
authors.affiliation: Department of Palliative Care, Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan nakajy@dream.ocn.ne.jp.
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Nakajima
authors.affiliation: Department of Surgery, Tenshi Hospital, Sapporo, Japan.
authors.forename: Kenju
authors.initials: K
authors.lastname: Kusumoto
authors.affiliation: Department of Psycho-Oncology, Saitama Medical University, Hidaka, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Onishi
authors.affiliation: Department of Psycho-Oncology, Saitama Medical University, Hidaka, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Ishida
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D003142:Communication; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D011379:Prognosis; D011787:Quality of Health Care / Q000592:standards*; D019452:Terminally Ill / Q000523:psychology*; D014342:Truth Disclosure
keywords: Support Team Assessment Schedule (STAS); cancer; communication; disclosure of cancer; oncology; terminal care