Abstract
Background
The mental distress suffered by cancer patients after telling them the truth about their diagnosis, is one of the main reasons why disclosure of cancer is not becoming more common in Japan. Using the State-Trait Anxiety Inventory (STAI), a self-rating scale, we assessed the anxiety level among cancer patients given information about their disease.
Methods
One hundred and sixty-one patients were solicited for participation in this study and complete answers to the Inventory were obtained from 118 patients. The STAI was administered twice, on the day of admission and after a precise explanation of the patient's disease, and was later compared. The information the patients had been given about their disease prior to admission, and the later explanations from the 8 attending physicians, given at the time of informed consent to treatment, were reviewed. The patients were divided into the following 4 groups according to the explanations given by the doctors; (1) 32 patients needed treatment for benign diseases, (2) 18 patients (all had cancers of digestive organs) were told euphemistically that they had tumors that required treatment, (3) 23 patients were newly diagnosed with cancer after admission, and (4) 41 patients had the same diagnosis of cancer as they had before admission. The remaining 4 patients were excluded because of an incorrect diagnosis.
Results
Many patients showed high State (43–72%) and Trait (21–46%) anxiety levels on admission. There was, however, no difference in the STAI scores between the 4 groups. The State anxiety scores in most of the patients with benign diseases were reduced to the normal range after explanation. Scores for those patients told euphemistically about their condition were also decreased significantly after admission, but their overall anxiety levels were still high. The patients diagnosed with cancer before admission and those newly diagnosed showed no significant changes in their STAI scores.
Conclusion
Anxiety remains high in cancer patients after clear or even euphemistic disclosure of cancer. This study demonstrated that giving patients an ambiguous explanation about their disease did not bring about additional emotional stability, and the anxiety already present did not get worse, even when the diagnosis was changed from tumors with the possibility of cancer to definite cancer.
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Hyodo, I., Jinno, K., Tanimizu, M. et al. Analysis of anxiety in cancer patients: The effects of telling the truth. Int J Clin Oncol 1, 113–117 (1996). https://doi.org/10.1007/BF02348277
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DOI: https://doi.org/10.1007/BF02348277