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Towards more prognostic information to patients with life threatening diseases: Why, how and when?

Hoff, Lena LU (2015) In Lund University Faculty of Medicine Doctoral Dissertation Series 2015:105.
Abstract
Physicians’ attitudes towards disclosure to patients of cancer diagnoses have changed from non-disclosure to full disclosure. Also disclosure of prognosis are likewise said to have changed, though not to the same degree. The overriding aim of this dissertation is to analyse information disclosed to patients with severe cancer prognoses, from a Swedish perspective, through two sets of interviews with patients and doctors. The aim of the first study (I) is to explore how the interviewed patients related to the information given them by their physicians. The second study (II) focuses how the information the patients received, concerning the severity of their illness, related to their awareness (or lack thereof). In the third study (III)... (More)
Physicians’ attitudes towards disclosure to patients of cancer diagnoses have changed from non-disclosure to full disclosure. Also disclosure of prognosis are likewise said to have changed, though not to the same degree. The overriding aim of this dissertation is to analyse information disclosed to patients with severe cancer prognoses, from a Swedish perspective, through two sets of interviews with patients and doctors. The aim of the first study (I) is to explore how the interviewed patients related to the information given them by their physicians. The second study (II) focuses how the information the patients received, concerning the severity of their illness, related to their awareness (or lack thereof). In the third study (III) conducted several years later, physicians were interviewed about what information to disclose to patient in (four) situations where relevant scientific knowledge is lacking or uncertain. In the fourth study (IV) the interviews, from both perspectives, were further analysed in order to explore, how the patient’s impending death is communicated.

The main finding of these papers is the discrepancy there is between patients’ desires for honest information and physicians’ reluctance to prognosticate until patients have overt signs of approaching death. The conclusion of this thesis is that, as a rule, patients should be more and better informed about their prognoses, unless the patient is clearly opposed to receiving such information or otherwise not a suitable partner for dialogue. (Less)
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author
supervisor
opponent
  • Associate professor Löfmark, Rurik, Karolinska Institute
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Prognostic information, acute leukemia, myeloma and inoperable lung cancer, ethics, values
in
Lund University Faculty of Medicine Doctoral Dissertation Series
volume
2015:105
pages
64 pages
publisher
Department of Medical Ethics, Lund University
defense location
Segerfalksalen, BMC A10, Sölvegatan 17, Lund
defense date
2015-10-17 10:00
ISSN
1652-8220
ISBN
978-91-7619-184-2
language
English
LU publication?
yes
id
0e71d665-ad90-449b-9d6d-0d48f23788eb (old id 7855338)
date added to LUP
2015-09-11 09:18:56
date last changed
2016-09-19 08:44:50
@phdthesis{0e71d665-ad90-449b-9d6d-0d48f23788eb,
  abstract     = {Physicians’ attitudes towards disclosure to patients of cancer diagnoses have changed from non-disclosure to full disclosure. Also disclosure of prognosis are likewise said to have changed, though not to the same degree. The overriding aim of this dissertation is to analyse information disclosed to patients with severe cancer prognoses, from a Swedish perspective, through two sets of interviews with patients and doctors. The aim of the first study (I) is to explore how the interviewed patients related to the information given them by their physicians. The second study (II) focuses how the information the patients received, concerning the severity of their illness, related to their awareness (or lack thereof). In the third study (III) conducted several years later, physicians were interviewed about what information to disclose to patient in (four) situations where relevant scientific knowledge is lacking or uncertain. In the fourth study (IV) the interviews, from both perspectives, were further analysed in order to explore, how the patient’s impending death is communicated. <br/><br>
 The main finding of these papers is the discrepancy there is between patients’ desires for honest information and physicians’ reluctance to prognosticate until patients have overt signs of approaching death. The conclusion of this thesis is that, as a rule, patients should be more and better informed about their prognoses, unless the patient is clearly opposed to receiving such information or otherwise not a suitable partner for dialogue.},
  author       = {Hoff, Lena},
  isbn         = {978-91-7619-184-2},
  issn         = {1652-8220},
  keyword      = {Prognostic information,acute leukemia,myeloma and inoperable lung cancer,ethics,values},
  language     = {eng},
  pages        = {64},
  publisher    = {Department of Medical Ethics, Lund University},
  school       = {Lund University},
  series       = {Lund University Faculty of Medicine Doctoral Dissertation Series},
  title        = {Towards more prognostic information to patients with life threatening diseases: Why, how and when?},
  volume       = {2015:105},
  year         = {2015},
}