How should we talk about acute leukaemia to adult patients and their families?

Problems of communication with patients with acute leukaemia and their families were explored by interviewing the next of kin of 26 patients, six of whom were still alive. In all but two cases the diagnosis had been disclosed to the relatives before the patient, but almost one-third of the relatives were not entirely satisfied with the way in which the diagnosis was presented. Medical prognostications at these initial interviews were, on the whole, regarded as being realistic by the relatives. Nine patients learnt of their diagnosis at an early stage, but relatives were undecided whether patients should be told of the diagnosis in explicit terms. Patients often established complete dependence on the hospital and its staff and had difficulties in relating to their own general practitioners while at home during their illness. Social chats were preferred by the relatives rather than regular progress reports from the doctors.