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Breaking Bad News: Preferences of Cancer Patients in Saudi Arabia

Syed Mustafa Karim, Jamal M Zekri, Sawsan Bassi, Baker bin Sadiq, Ehab M Abdelghany, Hossam Abdelrahman and Elshami Elamin

Background: It is believed in some Middle Eastern (ME) cultures that disclosure of bad news to cancer patients may cause loss of hope. This is often used to justify withholding such news. In this study, we examine cancer patients ‘preference regarding breaking bad news and disease information disclosure to them. Patients and Methods: Nine close ended questions addressing patient’s disclosure preference and one question addressing timing of disclosure to the family were designed in a questionnaire format and were answered by cancer patients in an outpatient setting. Affirmative “Yes” answer indicates preference to be informed of bad news. Results: One hundred patients were recruited and answered the questions. 87% of patients preferred to be informed of their cancer diagnosis. There was no statistically significant effect of age, gender, education level, professional status, diagnosis and stage of disease on this preference. 98% wanted to know of serious news about their health. 60% of patients answered “Yes” to 8 or 9 questions. Age ≥ 50 compared to <50 years was the only factor significantly associated with likelihood of affirmative response to 8 or 9 questions (Chi2 P=0.027). Conclusions: Our study indicates that most cancer patients in Saudi Arabia prefer to know the diagnosis of cancer and any related poor outcomes, and to be involved in decision making throughout the course of their illness. This is in congruence with results of other studies from other parts of the world. Given this accumulating body of evidence, healthcare provider should, whenever possible, keep the patients involved in the decision making process throughout the cancer journey.

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