Physician, patient and family attitudes regarding information on prognosis: a Brazilian survey

Abstract

Background: Communication between physicians and patients is a fundamental aspect of cancer care, yet most physicians’ perceptions are often inconsistent with the patients’ stated preferences while prognostic information is the most misunderstood. Patients and methods: Members of the Brazilian Society of Oncology Physicians (n = 609) were identified and asked to complete a mailed questionnaire. Outpatients (n = 150) and their family members (n = 150), oncologists and fellows (n = 55) from a public healthcare hospital and a tertiary cancer hospital in Sao Paulo were also personally invited to participate. Results: A total of 202 physicians, 150 outpatients and 150 family members were participated. The majority of patients (92%) believe they should know about their terminal stage compared with 79.2% of physicians and 74.7% of families (P = 0.0003). Cancer patients were most likely to support disclosure of diagnosis and terminality (P = 0.001), to consider that this disclosure was not stressful (P < 0.0001) and that this knowledge would improve their quality of life (P < 0.0001). Conclusions: Cancer patients seen in these centers in Southeastern Brazil prefer to know the truth about their poor prognosis more than their physicians and families think. Further studies with larger samples of patients and physicians are necessary to show if our results are representative of all Brazilian situations.