Oral Presentation COSA-IPOS Joint Scientific Meeting 2012

Reasons for and for not disclosing, illness perceptions, and psychological adjustment in Indian caregivers of cancer patients (#91)

Mahati Chittem 1 , Paul Norman 2 , Peter Harris 2
  1. Indian Institute of Technology Hyderabad, Yeddumailaram, AP, India
  2. Psychology, University of Sheffield, Sheffield, Yorkshire, UK

Aims. Nondisclosure of a cancer diagnosis is common in many Asian countries which follow a family-centered approach to medical decision-making. However, there is little research exploring the factors that distinguish between caregivers who choose to disclose or not disclose to patients about their cancer diagnosis. Methods. The accrual target of 200 was exceeded, with 154 Indian disclosing and 165 non-disclosing caregivers completing the Hospital Anxiety and Depression Scale, Brief Illness Perceptions Questionnaire, and a checklist of 18 reasons for, and 18 reasons for not, disclosing the cancer diagnosis. The checklists were based on a qualitative study that explored Indian caregivers’ beliefs about cancer diagnosis (non)disclosure. Results. The reasons for and for not disclosing were the only variables that significantly differentiated between disclosing and non-disclosing caregivers in a multivariate discriminant function analysis, chi-quare (10) = 599.44, p <.001. Further analyses indicated that preparing the patient and patient’s personality were the most important reasons for disclosing, chi-square (6) = 589.55, p <.001, whereas patient’s personality and caregivers’ fear for patients’ longevity were the most important reasons for not disclosing, chi-square (8) = 368.29, p <.001. Conclusions. A key finding was that only reasons for and for not disclosing determined caregiver group membership, suggesting that using a checklist of reasons for and for not disclosing to patients about their cancer diagnosis may help understand caregivers' disclosure decisions better. Preparing the patient and strength of the patient’s personality were key reasons for disclosing.  Therefore, disclosing caregivers could be offered advice regarding how to best prepare patients for the cancer process after disclosure. However, caregivers’ belief that the patient was weak and that disclosing would jeapordise the illness outcomes were key reasons for not disclosing. Therefore, healthcare staff may need to address caregivers’ negative perceptions of patient’s personality and negative link between disclosure and longevity.