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Japanese Journal of Clinical Oncology Advance Access originally published online on February 3, 2009
Japanese Journal of Clinical Oncology 2009 39(4):201-216; doi:10.1093/jjco/hyn159
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© The Author (2009). Published by Oxford University Press. All rights reserved

Preferences of Cancer Patients Regarding Communication of Bad News: A Systematic Literature Review

Maiko Fujimori1,2 and Yosuke Uchitomi2

1 Research Fellowships of the Japan Society for the Promotion of Science for Young Scientists
2 Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan

For reprints and all correspondence: Yosuke Uchitomi, Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwanoha 6-5-1, Kashiwa, Chiba 277-8577, Japan. E-mail: yuchitom{at}east.ncc.go.jp

Received September 1, 2008; accepted December 24, 2008

Most physicians regard the communication of bad news to be a difficult issue in clinical oncology practice. The optimal manner of communicating bad news to patients so that physicians can create maximal understanding in patients and facilitate their psychological adjustment is unknown. A systematic review of the literature was conducted to clarify available knowledge on patient preferences regarding the communication of bad news and associated factors. A comprehensive computer search of databases (MEDLINE and PsychINFO) and a manual search identified 24 studies. The above issue has been discussed mainly in Western countries. Most studies used different measures to obtain information on patient preferences and have provided mostly descriptive evidence. The findings in this review suggest that patient preferences with regard to the communication of bad news by physicians consist of four components: setting, manner of communicating bad news, what and how much information is provided and emotional support, and that patients' preferences are associated with demographic factors. Younger patients, female patients and more highly educated patients consistently expressed a desire to receive as much detailed information as possible and to receive emotional support. Asian patients were shown to prefer that relatives be present when receiving bad news more than Westerners do and to prefer to discuss their life expectancy less than Westerners. Physicians need to recognize these preferences to help patients understand.

Key Words: communication • patient preferences • bad news • review


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