Información al paciente en situación terminal: diferencias entre las publicaciones anglosajonas y la experiencia diaria en España

Abstract

This paper attempts to ascertain the evolution during the last decade of the perceived cultural differences between the Anglo-Saxon world and the rest of the world (Spain), on information regarding diagnosis and prognosis given to terminal patients, and their families.A non-systematic review was conducted on the literature over the past 10 years. Only a few aspects have been selected intentionally, those believed by the author to be influential on our perceptions of change.Several issues have been reviewed: a) systematic reviews of the literature on information and their conclusions, b) studies with results that the author believes might change our previous perceptions, c) attempts to construct transcultural evaluating tools (with a special reference to the work on the locus of control), and d) limitations of the existing training programs on communication skills. The present paper also suggests a proposal for the health professional who wishes to provide information on the diagnosis and prognosis in Spain, based on the review of the literature, and the everyday clinical experience of the author. Finally, some clinical cases help to illustrate the complexity of the problem in both cultural environments (Anglo-Saxon and Spanish).Research related to truth-telling in terminal patients seems to suggest, notwithstanding some minor aspects, the existence of some common concerns that bridge traditional cultural barriers. Also, there seems to be a generalisation, within the professionals working in different cultural environments, of a new measured and individually tailored information process. Lastly, early collaboration of the hospital palliative care programs with the oncology programs might become a promising alternative in order to solve communication issues in advanced cancer, that seem to be contributing to an important misuse of our limited financial health resources.