Challenges of Truth-telling to Patients and Their Families: A Qualitative Study

Abstract

Background: The issue of truth-telling by healthcare providers is critically important, and it has legal and ethical implications. Objectives: This study was conducted to investigate the perceptions and preferences of patients, families, and healthcare providers related to truth disclosure to identify barriers to this important aspect of communication. Methods: A total of 27 participants (4 patients, 7 family members, 4 physicians, and 12 nurses) were recruited by purposeful sampling. Data were collected through in-depth, semi-structured interviews and analyzed by qualitative thematic analysis. Results: Three main themes and eight sub-themes emerged from the data: (1) truth shock: Patient inability to face the truth, family inability to handle the truth; (2) secrecy during treatment and recovery: Withholding critical information from patients and families; family confusion about the patient’s condition; families preventing truth disclosure to the patient; family fear of the truth’s impact on the patient; and (3) patient's right to information: Lack of patient awareness of their rights; the importance of informing patients about their condition. Conclusions: The findings of this study suggest that healthcare providers can deliver bad news to patients and their families more effectively and satisfyingly using an approach based on culture, patient preferences, and ethical values