TY - JOUR
T1 - Explicit prognostic disclosure to Asian women with breast cancer
T2 - A randomized, scripted video-vignette study (J-SUPPORT1601)
AU - Mori, Masanori
AU - Fujimori, Maiko
AU - van Vliet, Liesbeth M.
AU - Yamaguchi, Takuhiro
AU - Shimizu, Chikako
AU - Kinoshita, Takayuki
AU - Morishita-Kawahara, Miki
AU - Inoue, Akira
AU - Inoguchi, Hironobu
AU - Matsuoka, Yutaka
AU - Bruera, Eduardo
AU - Morita, Tatsuya
AU - Uchitomi, Yosuke
N1 - Funding Information:
This study was part of the Japan Supportive, Palliative, and Psychosocial Oncology Group study (J-SUPPORT1601) and was supported by The National Cancer Center Research and Development Fund (27-A-3), and Health, Labor, and Welfare Sciences Research Grants: Research for Promotion of Cancer Control Programs (H26-Cancer Control-general-002 and H29-Cancer Control-general-017). LV is supported by a Young Investigator Grant (number 10392) of the Dutch Cancer Society.
Publisher Copyright:
© 2019 American Cancer Society
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Background: Nondisclosure of a poor prognosis to patients with advanced cancer remains a typical practice in Asia. Although the importance of prognostic communication has increasingly been recognized worldwide, little is known about whether explicit prognostic disclosure positively affects Asian patients with advanced cancer. The objective of this study was to examine the effects of explicit prognostic communication on patients with cancer recurrence. Methods: In this randomized, video-vignette study, Japanese women with breast cancer who had undergone curative surgery viewed videos of prognostic communication between a patient with recurrent, incurable breast cancer and her oncologist. The videos differed only in the presence or absence of explicit prognostic disclosure. The primary outcome was participants' uncertainty (rated from 0 to 10), and the secondary outcomes included anxiety (measured on the State-Trait Anxiety Inventory-State: range, 20-80), satisfaction (Patient Satisfaction Questionnaire; range 0-10), self-efficacy (range, 0-10), and willingness to discuss advance care planning (range, 1-4). Results: In total, 105 women participated (mean ± SD age, 53.8 ± 8.2 years). After viewing the video with more versus less explicit disclosure, participants showed significantly lower uncertainty (mean ± SE scores, 5.3 ±0.2 vs 5.7 ± 0.2, respectively; P =.032) and higher satisfaction (5.6 ± 0.2 vs 5.2 ± 0.2, respectively; P =.010) without increasing anxiety (changes in scores on the State-Trait Anxiety Inventory-State: 0.06 ± 0.5 vs 0.6 ± 0.5, respectively; P =.198). No significant differences were observed in self-efficacy (5.2 ± 0.2 vs 5.0 ± 0.2, respectively; P =.277) or willingness to discuss advance care planning (2.7 ± 0.1 vs 2.7 ± 0.1, respectively; P =.240). Conclusions: Explicit prognostic disclosure prompted better outcomes than nondisclosure in Japanese women with breast cancer. When asked about the prognosis by Asian patients with cancer, clinicians may be encouraged to respect their wishes and explicitly discuss the prognosis if deemed appropriate.
AB - Background: Nondisclosure of a poor prognosis to patients with advanced cancer remains a typical practice in Asia. Although the importance of prognostic communication has increasingly been recognized worldwide, little is known about whether explicit prognostic disclosure positively affects Asian patients with advanced cancer. The objective of this study was to examine the effects of explicit prognostic communication on patients with cancer recurrence. Methods: In this randomized, video-vignette study, Japanese women with breast cancer who had undergone curative surgery viewed videos of prognostic communication between a patient with recurrent, incurable breast cancer and her oncologist. The videos differed only in the presence or absence of explicit prognostic disclosure. The primary outcome was participants' uncertainty (rated from 0 to 10), and the secondary outcomes included anxiety (measured on the State-Trait Anxiety Inventory-State: range, 20-80), satisfaction (Patient Satisfaction Questionnaire; range 0-10), self-efficacy (range, 0-10), and willingness to discuss advance care planning (range, 1-4). Results: In total, 105 women participated (mean ± SD age, 53.8 ± 8.2 years). After viewing the video with more versus less explicit disclosure, participants showed significantly lower uncertainty (mean ± SE scores, 5.3 ±0.2 vs 5.7 ± 0.2, respectively; P =.032) and higher satisfaction (5.6 ± 0.2 vs 5.2 ± 0.2, respectively; P =.010) without increasing anxiety (changes in scores on the State-Trait Anxiety Inventory-State: 0.06 ± 0.5 vs 0.6 ± 0.5, respectively; P =.198). No significant differences were observed in self-efficacy (5.2 ± 0.2 vs 5.0 ± 0.2, respectively; P =.277) or willingness to discuss advance care planning (2.7 ± 0.1 vs 2.7 ± 0.1, respectively; P =.240). Conclusions: Explicit prognostic disclosure prompted better outcomes than nondisclosure in Japanese women with breast cancer. When asked about the prognosis by Asian patients with cancer, clinicians may be encouraged to respect their wishes and explicitly discuss the prognosis if deemed appropriate.
KW - bad news
KW - explicitness
KW - prognostic disclosure
KW - uncertainty
KW - video-vignette study
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U2 - 10.1002/cncr.32327
DO - 10.1002/cncr.32327
M3 - Article
C2 - 31206639
AN - SCOPUS:85067465394
SN - 0008-543X
VL - 125
SP - 3320
EP - 3329
JO - Cancer
JF - Cancer
IS - 19
ER -