VOL: 96, ISSUE: 37, PAGE NO: 48
Maria Leadbeater, BA, RGN, is a cancer information nurse, Weston Park Hospital, SheffieldCancer will affect one in three people (Farncombe, 1994). Attempting to understand the emotional impact of a cancer diagnosis is the first step for the health care professional towards helping the patient accept, and adjust to, their illness.
Cancer will affect one in three people (Farncombe, 1994). Attempting to understand the emotional impact of a cancer diagnosis is the first step for the health care professional towards helping the patient accept, and adjust to, their illness.
Researchers have found that providing patients with information about their condition reduces their fear and anxiety, enhances their understanding and can actually reduce some of the side-effects of cancer treatments (Kerrigan et al, 1993; Poroch, 1995).
The Calman-Hine report (1995) advocates the general principal that 'patients, families and carers should be given clear information and assistance in a form they can understand about treatment options and outcomes available to them at all stages of treatment; from diagnosis onwards'. In 1996, a study by the National Cancer Alliance found that patients diagnosed with cancer most often complained of a lack of adequate information.
Patients often report the moment of diagnosis as upsetting but, on reflection, see it as the point at which coping begins (Walker et al, 1996). But patients need accurate and factual information so that they can develop an understanding of their illness.
To facilitate information exchanges, such as details regarding treatment and support, Brewin (1991) suggests that 'bad news' should be given in an understanding and positive way and that communicating this information in a blunt, unfeeling or negative way tends to limit the scope for further discussion.
Barriers to imparting information
Professionals may alter the content of the information they communicate to patients according to what they believe the patient needs to know. Nobel (1996) recommends that health care professionals should establish what the patient wants to know, before communicating the information in 'sizeable chunks'.
Allowing the patient to obtain information at their own pace would seem the ideal solution. Faulkner (1998) recommends the use of a patient-led agenda. This allows the patient to describe their situation from their own perspective and ensures that treatment priorities correspond to patients' needs.
Health professionals can also experience anxiety and distress at the time of diagnosis. Maguire (1985) realised that distancing tactics and avoiding open discussion ensured doctors' own emotional survival. It would appear that the distress of both patient and health professional may affect what information is given or omitted at diagnosis.
Research demonstrates that patients want as much information as possible regarding their condition (Fallowfield et al, 1995; Meredith et al, 1996). However, the timing and the amount of information varies according to the individual patient. Patients should be encouraged to ask questions that they feel are important to them, and nurses and other health professionals should be able to provide accurate answers which will be understood by the patient.
CancerBACUP, tel: 0800 181 199
CancerLink, tel: 020 7833 2818
The National Cancer Alliance report, Patient-Centred Services: What Patients Say, is available from PO Box 579, Oxford OX4 1LB, tel: 01865 793566, price £12 inc p&p.