Impact of Diagnosis Disclosure/Non-disclosure on Quality of Life of Patients with Early and Middle Stage Liver Cancer / 中国医学伦理学

ABSTRACT

It is common that families of cancer patients ask physicians to non-disclose the diagnosis from the patients for purpose of protecting their emotion and quality of life (QOL), but it is conflicted with patients’ increasing demands for right to know in China. Therefore, it is urgent to verify whether non-disclosure (or disclosure) of the diagnosis is more beneficial to patients’ QOL, and provide research evidence for solving the dilemma of non-disclosure or disclosure in medical decision-making. 300 hospitalized patients with early/middle stage liver cancer were recruited, including 162 patients in the disclosure group and 138 patients in the non-disclosure group. The patients’ QOL scale were evaluated at the time of admission, 1 month, 3 months, and 6 months after discharge. The social support scale, trait coping style and trait anxiety/depression scale were assessed at admission. The results showed that 91.30% of the patients in the non-disclosure group knew of the diagnosis of liver cancer by their own way after discharge. The scores of emotional functioning and overall QOL were significantly higher in the disclosure group than those in the non-disclosure group at first month after discharge (P<0.01). At six months after discharge, among the 52 patients with cancer recurrence, the scores of emotional functioning and overall QOL were higher in the disclosure group than those in the non-disclosure group (P<0.05). Additionally, the multivariate analysis showed that, in the presence of age, trait anxiety/depression, social support and other influencing factors, disclosure of diagnosis was positively correlated with the overall QOL at 1 and 6 months after discharge (P<0.05). It indicated that disclosure of cancer diagnosis during hospitalization is more beneficial to improve the QOL of patients with early and middle stage cancer.