title: Truth telling in Taiwanese cancer care: patients' and families' preferences and their experiences of doctors' practices.
abstract: Despite the significant role played by cancer patients' families in medical decision-making in Asian countries, inconsistencies have hitherto not been evaluated between patients' and families' preferences and doctors' actual practices with regard to cancer truth telling.
  
  
  
  For this quantitative comparative study of cancer patients' and families' truth-telling preferences and their experiences of doctors' practices, 532 patients, 551 family members, and 127 doctors (N = 1 210) were enrolled from five hospitals across Taiwan over 2 years. Truth telling was assessed using the Taiwanese version of a modified Japanese truth-telling scale.
  
  
  
  Patients' truth-telling preferences and their experiences of doctors' truth-telling practices differed significantly in scores on the overall truth-telling scale and each subscale, including method of disclosure, emotional support, additional information, and setting (P < .001). Similar findings were obtained for families' preferences and doctors' actual practices (P < .001). Patients' and families' truth-telling preference scores were higher than doctors' actual practice scores. Multiple regression analysis revealed a dose-dependent effect of doctors' monthly truth-telling frequency on their truth-telling preferences, but this effect was only borderline significant (P = .08). This multiple regression model explained 30% of the total variance in doctors' truth-telling preferences (F = 1.38, P = .22).
  
  
  
  Taiwanese medical educational policies need to be revised to better equip doctors to practice truth telling in accordance with the preferences of cancer patients and families. Communication skills training should be prioritized for doctors who refrain from truth telling in actual practice.
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Woung-Ru
authors.initials: WR
authors.lastname: Tang
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Ji-Hong
authors.initials: JH
authors.lastname: Hong
authors.affiliation: Department of Hematology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Kun-Ming
authors.initials: KM
authors.lastname: Rau
authors.affiliation: Department of Hematology, Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Cheng-Hsu
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yeong-Yuh
authors.initials: YY
authors.lastname: Juang
authors.affiliation: Department of Hematology, Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Chien-Hong
authors.initials: CH
authors.lastname: Lai
authors.affiliation: Center for Suicide Prevention, National Institute of Mental Health, National Center for Neurology & Psychiatry, Tokyo, Japan.
authors.forename: Maiko
authors.initials: M
authors.lastname: Fujimori
authors.affiliation: Department of Psychiatry, Suicide Prevention Center & Hospice and Palliative Care Center, MacKay Memorial Hospital, Taipei, Taiwan.|Department of Medicine, MacKay Medical College, New Taipei, Taiwan.|Department of Thanatology and Health Counseling, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
authors.forename: Chun-Kai
authors.initials: CK
authors.lastname: Fang
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D009369:Neoplasms / Q000628:therapy*; D057240:Patient Preference / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013624:Taiwan; D014342:Truth Disclosure
keywords: cancer; clinical practice; medical decision-making; psycho-oncology; truth telling