title: Awareness of cancer, satisfaction with care, emotional distress, and adjustment to illness: an Italian multicenter study.
abstract: OBJECTIVE
  The aim of the study was to examine awareness of cancer and the relationship with distress and satisfaction with care among Italian cancer patients.
  
  
  METHODS
  Two hundred sixty-two cancer patients consecutively admitted to the Day Hospital of four cancer centers in Italy completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core-30, the EORTC Inpatient Satisfaction-32, the EORTC Information Questionnaire-25, the distress thermometer, the Mini-mental Adjustment to Cancer scale, a visual analogue scale of illness awareness, and questions related to the admission and unmet needs.
  
  
  RESULTS
  Eighty-seven percent of patients were aware of their diagnosis, but 49% of those with metastatic cancer thought they have a curable disease. About one-third felt that family members often (16%) or always (13%) were hiding information or bad news in order to protect them. In multivariate analysis, the perception of being protected from bad news by the family was associated with the perceived need to talk more with the family but was not associated with demographic or clinical (Karnofsky Performance Status and stage) variables, lower emotional distress, and greater satisfaction with care and information. Also, awareness of diagnosis and prognosis was not associated with demographic or clinical variables, emotional distress, or satisfaction with care and information
  
  
  CONCLUSIONS
  Most cancer patients were fully informed about their diagnosis, although awareness of disease was not coincident with awareness of prognosis and disease progression. Information and knowledge were not destructive of hope and did not increase distress. Family issues are still a significant factor molding openness and sharing of information.
authors.affiliation: Psycho-Oncology Departmental Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology, La Sapienza University of Rome, Rome, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Costantini
authors.affiliation: Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.|University Hospital Psychiatry Unit, Psycho-Oncology and Psychiatry in Palliative Care Program, Department of Mental Health, Ferrara, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Grassi
authors.affiliation: Mental Health Unit, Centre of Epidemiology, Surveillance, and Health Promotion, Italian National Institute of Health, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Picardi
authors.affiliation: Psycho-Oncology Departmental Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology, La Sapienza University of Rome, Rome, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Brunetti
authors.affiliation: Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.|University Hospital Psychiatry Unit, Psycho-Oncology and Psychiatry in Palliative Care Program, Department of Mental Health, Ferrara, Italy.
authors.forename: Rosangela
authors.initials: R
authors.lastname: Caruso
authors.affiliation: Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.|University Hospital Psychiatry Unit, Psycho-Oncology and Psychiatry in Palliative Care Program, Department of Mental Health, Ferrara, Italy.
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Nanni
authors.affiliation: Psycho-Oncology Service, Azienda Ospedaliera Treviglio, Treviglio, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Bonetti
authors.affiliation: Clinical Psychology Unit, Medical Oncology Unit, San Paolo Hospital, Bari, Italy.
authors.forename: Rossana
authors.initials: R
authors.lastname: de Feudis
authors.affiliation: Division of Medical Oncology, Azienda Ospedaliera Treviglio, Treviglio, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Barni
authors.affiliation: Unit of Medical Oncology, Sant'Andrea Hospital, Faculty of Medicine and Psychology, La Sapienza University of Rome, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Marchetti
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: awareness; cancer; distress; oncology; quality of life; satisfaction