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Factors associated with patient preferences for communication of bad news

Published online by Cambridge University Press:  02 November 2016

Maiko Fujimori ,
Tatsuo Akechi  and
Yosuke Uchitomi
Maiko Fujimori*
Affiliation:
Office for Promotion of Support for Suicide Survivor, Japan Support Center for Suicide Countermeasures, National Institute of Mental Health, National Center for Neurology and Psychiatry, Tokyo, Japan Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
Tatsuo Akechi
Affiliation:
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
Yosuke Uchitomi
Affiliation:
Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
*
Address correspondence and reprint requests to: Maiko Fujimori, Office for Promotion of Support for Suicide Survivor, Japan Support Center for Suicide Countermeasures, National Institute of Mental Health, National Center for Neurology and Psychiatry, Ogawa-Higashi 4-1-1, Kodaira, Tokyo 187-8551, Japan. E-mail: mfujimor@ncc.go.jp.
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Abstract

Objective:

Communication based on patient preferences can alleviate their psychological distress and is an important part of patient-centered care for physicians who have the task of conveying bad news to cancer patients. The present study aimed to explore the demographic, medical, and psychological factors associated with patient preferences with regard to communication of bad news.

Methods:

Outpatients with a variety of cancers were consecutively invited to participate in our study after their follow-up medical visit. A questionnaire assessed their preferences regarding the communication of bad news, covering four factors—(1) how bad news is delivered, (2) reassurance and emotional support, (3) additional information, and (4) setting—as well as on demographic, medical, and psychosocial factors.

Results:

A total of 529 outpatients with a variety of cancers completed the questionnaire. Multiple regression analyses indicated that patients who were younger, female, had greater faith in their physician, and were more highly educated placed more importance on “how bad news is delivered” than patients who were older, male, had less faith in their physician, and a lower level of education. Female patients and patients without an occupation placed more importance on “reassurance and emotional support.” Younger, female, and more highly educated patients placed more importance on “additional information.” Younger, female, and more highly educated patients, along with patients who weren't undergoing active treatment placed more importance on “setting.”

Significance of Results:

Patient preferences with regard to communication of bad news are associated with factors related to patient background. Physicians should consider these characteristics when delivering bad news and use an appropriate communication style tailored to each patient.

Keywords

CommunicationPatient preferencesBad newsPatient–oncologist relationship
Type
Original Articles
Information
Palliative & Supportive Care , Volume 15 , Issue 3 , June 2017 , pp. 328 - 335
Copyright
Copyright © Cambridge University Press 2016 

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