title: Breaking Bad News: Patient Preferences and the Role of Family Members when Delivering a Cancer Diagnosis.
abstract: BACKGROUND
  Western physicians tend to favour complete disclosure of a cancer diagnosis to the patient, while non-Western physicians tend to limit disclosure and include families in the process; the latter approach is prevalent in clinical oncology practice in India. Few studies, however, have examined patient preferences with respect to disclosure or the role of family members in the process.
  
  
  METHODS
  Structured interviews were conducted with patients (N=127) in the medical oncology clinic of a tertiary referral hospital in Bangalore, India.
  
  
  RESULTS
  Patients ranged in age from 18-88 (M=52) and were mostly male (59%). Most patients (72%) wanted disclosure of the diagnosis cancer, a preference significantly associated with higher education and English proficiency. A majority wanted their families to be involved in the process. Patients who had wanted and not wanted disclosure differed with respect to their preferences regarding the particulars of disclosure (timing, approach, individuals involved, role of family members). Almost all patients wanted more information concerning their condition, about immediate medical issues such as treatments or side effects, rather than long-term or non-medical issues.
  
  
  CONCLUSIONS
  While most cancer patients wanted disclosure of their disease, a smaller group wished that their cancer diagnosis had not been disclosed to them. Regardless of this difference in desire for disclosure, both groups sought similar specific information regarding their cancer and largely favoured involvement of close family in decision making. Additional studies evaluating the influence of factors such as disease stage or family relationships could help guide physicians when breaking bad news.
authors.affiliation: St. John's Research Institute Medical College Hospital, Bangalore, India E-mail : arunshet1@gmail.com.
authors.forename: Abha
authors.initials: A
authors.lastname: Rao
authors.forename: Maria
authors.initials: M
authors.lastname: Ekstrand
authors.forename: Elsa
authors.initials: E
authors.lastname: Heylen
authors.forename: Girish
authors.initials: G
authors.lastname: Raju
authors.forename: Arun
authors.initials: A
authors.lastname: Shet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D057240:Patient Preference; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D055815:Young Adult