Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt.
Clinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt.
JCO Glob Oncol. 2022 Jun;8:e2200080. doi: 10.1200/GO.22.00080.
In many countries, including Egypt, it is still believed that not telling patients their cancer diagnosis is associated with less psychological morbidity. This study was conducted to explore whether not telling Egyptian patients their cancer diagnosis is associated with less anxiety and depression and better quality-of-life (QoL) or not.
A cross-sectional observational study was conducted in two Egyptian cancer care facilities and included 292 adult patients with cancer of whom 197 (67%) were aware of their diagnosis and 95 (33%) were unaware. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression and the Functional Assessment of Cancer Therapy-General 7 questionnaire to assess QoL.
Patients unaware of their cancer diagnosis were significantly more likely to be less educated, with no family history of cancer, interviewed within 6 months of cancer diagnosis, diagnosed with a cancer other than breast and colorectal cancer, in a poorer performance status, and with no history of anticancer treatment. There was no significant difference between unaware and aware patients in the scores of HADS-Anxiety (median [interquartile range (IQR)] = 6 [3-11] and 7 [4-11], = .203), HADS-Depression (median [IQR] = 8 [4-12] and 8 [4-11], = .64), and Functional Assessment of Cancer Therapy-General 7 (median [IQR] = 16 [12-20] and 16 [11-21], = .754). In multiple regression analysis with adjustment, diagnosis unawareness did not associate significantly with anxiety, depression, and QoL ( = .394, .662, and .845, respectively).
The results of the current study confirm that not telling adult patients their cancer diagnosis is not associated with less anxiety and depression nor better QoL.
在许多国家，包括埃及，人们仍然认为不向患者告知癌症诊断结果与较少的心理发病率有关。本研究旨在探讨不向埃及患者告知癌症诊断结果是否与较少的焦虑、抑郁和更好的生活质量（QoL）有关。
这是一项在埃及两家癌症护理机构进行的横断面观察性研究，共纳入 292 名成年癌症患者，其中 197 名（67%）知晓自己的诊断，95 名（33%）患者则对此不知情。采用医院焦虑抑郁量表（HADS）评估焦虑和抑郁，采用癌症治疗功能评估-一般问卷（FACT-G）评估 QoL。
不知道自己患有癌症的患者受教育程度明显较低，无癌症家族史，在癌症诊断后 6 个月内接受访谈，诊断为乳腺癌和结直肠癌以外的癌症，表现状态较差，且无抗癌治疗史。在 HADS 焦虑评分（中位数[四分位距（IQR）]：6 [3-11] 和 7 [4-11]， =.203）、HADS 抑郁评分（中位数[IQR]：8 [4-12] 和 8 [4-11]， =.64）和 FACT-G 评分（中位数[IQR]：16 [12-20] 和 16 [11-21]， =.754）方面，不知道自己患有癌症的患者与知道自己患有癌症的患者之间没有显著差异。在多因素回归分析中，调整其他因素后，诊断知晓情况与焦虑、抑郁和 QoL 无显著相关性（ =.394、.662 和.845）。
本研究结果证实，不向成年患者告知癌症诊断结果与较少的焦虑、抑郁和更好的 QoL 无关。
