Physicians' attitudes to and problems with truth-telling to cancer patients

Disclosure of cancer diagnosis to patients represents a major problem in Italy among physicians. The aim of the study was to assess physicians’ attitudes and opinions about disclosure. A convenience sample of 675 physicians in Udine (North Italy) completed a ten-item questionnaire . About 45% indicated that, in principle, patients should always be informed of the diagnosis, but only 25% reported that they always disclose the diagnosis in practice. Physicians with a surgical specialization employed in general hospitals endorsed disclosure of the diagnosis more frequently than GPs and older physicians. One third of the responding physicians continue to believe that the patients never want to know the truth. The hospital rather than the patient’s home was considered as the most appropriate place to inform the patients among hospital doctors. The opposite result was found among GPs. Almost all of the physicians endorsed involving family members when disclosing the diagnosis, but, at the same time, they also indicated that families usually prefer their ill relative not to be informed. Ninety-five per cent of physicians believed that the GP should always be involved in diagnostic and communication process and 48% indicated that the GP should communicate the diagnosis to the patient (vs. the physician who made the diagnosis). Having guidelines for breaking bad news to patients was indicated as an important need by 86% of the responding physicians. Despite changes in medical education, improvement of communication skills in dealing with cancer patients and their family represents an important need in health settings