Basic Nursing 1st Edition by Judith Wilkinson, Leslie Treas

Exercise 21

Hancock, K., Claton, J. M., Parker, S. M., et al. (2007). Truth-telling in discussing prognosis in advanced life-limiting illnesses: A systematic review. Palliative Medicine, 21, 507-517.
This was a systematic review of 46 studies related to truth-telling in discussing prognosis with patients with progressive, advanced life-limiting illnesses and their caregivers. Results included the following:
• Many health professionals expressed discomfort at having to inform the patient and family of limited life expectancy.
• The majority of health professionals thought that patients and their caregivers should be told the truth about the prognosis.
• Nevertheless, many either avoid discussing the topic or withhold information.
• Reasons for not telling the truth include perceived lack of training, stress, no time to attend to the patient's emotional needs, fear of a negative effect on the patient, uncertainty about the prognosis, requests from family members to withhold information, and a feeling of inadequacy because further curative treatment was not available.
• Studies suggested that patients can discuss this topic without it having a negative impact on them.
Health professionals feared a negative effect on patients of telling them the truth about their condition. What sorts of negative effects do you think they might be anticipating?