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Experiences of truth disclosure in terminally ill cancer patients in palliative home care

Published online by Cambridge University Press:  04 May 2011

Maria Friedrichsen ,
Ann Lindholm  and
Anna Milberg
Maria Friedrichsen*
Affiliation:
Palliative Education and Research Center, The County of Östergötland, Vrinnevi Hospital, Norrköping, Sweden Department of Social & Welfare Studies, Linköping University, Linköping, Sweden Research and Development Department, Stockholms Sjukhem Foundation, Stockholm, Sweden
Ann Lindholm
Affiliation:
Research and Development Department, Stockholms Sjukhem Foundation, Stockholm, Sweden
Anna Milberg
Affiliation:
Department of Social & Welfare Studies, Linköping University, Linköping, Sweden Unit of Palliative Care, University Hospital, Linköping, Sweden
*
Address correspondence and reprint requests to: Maria Friedrichsen, Palliative Education and Research Centre in the County of Östergötland, Vrinnevi Hospital, 601 82 Norrköping, Sweden. E-mail: marfr@isv.liu.se
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Abstract

Objective:

The aim of this study was to explore the experiences and preferences of terminally ill cancer patients regarding truth telling in the communication of poor prognoses.

Method:

We recorded and transcribed interviews with 45 patients who knew their cancer was terminal, and analyzed their responses hermeneutically.

Results:

Patients identified three different modes of truth: (1) the absolute objective truth that they are dying; (2) the partial truth about their condition including some facts but not all of the details; and (3) the desired truth, originating in the patient's own beliefs about a healthy or better life. Coping strategies were related to patients’ preferred mode of truth: (1) facing the truth in order to take action; (2) facing some parts of the truth in order to maintain hope; and (3) hovering between facing and avoiding the truth. In their struggle for existential survival, patients used different coping strategies, changing from one to another depending upon the circumstances.

Significance of results:

Varying use of different coping strategies impacts on patient preferences concerning communication about bad news with their doctors. Truth-telling entails more than merely providing information related to the forthcoming death. It also concerns how physicians or other healthcare staff can support the patient's existential survival by fine-tuning the communication of “truth” according to the individuals’ preferences.

Type
Original Articles
Information
Palliative & Supportive Care , Volume 9 , Issue 2 , June 2011 , pp. 173 - 180
Copyright
Copyright © Cambridge University Press 2011

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