Breaking bad news in cancer : an assessment of Maltese patients’ preferences

Abstract

Purpose: It is unclear whether Maltese cancer patients wish to know their diagnosis or to what extent they want to be informed. The aim was to assess patients’ preferences for receiving a cancer diagnosis and being involved in the decision-making process, and then compare these with results from similar international studies.

Methods: Two hundred fifty-two Maltese adult cancer patients were invited to complete two standardised tools: the Measure of Patients’ Perspective (MPP), assessing patients’ preferences for receiving news about their cancer, and the Control Preferences Scale (CPS), examining involvement in decision-making.

Results: Maltese patients rated the ‘content’ subscale (information given; mean 4.17, SD 0.59) as significantly more important (p<0.001) than ‘support’ (offering comfort/support; mean 3.73, SD 0.68) and ‘facilitation’ (how information is given; mean 3.86, SD 0.68). Patients with higher levels of education had significantly higher scores for ‘content’ (p=0.018) and ‘facilitation’ (p<0.001) on the MPP, while lower education levels preferred a passive role (p=0.01) on the CPS. Although there is a trend towards a collaborative and even an active role in treatment decisions, patients still exhibit a paternalistic attitude towards their physician. Age, gender and medical variables had no significant influence on response.

Conclusions: Maltese cancer patients want to be informed of their cancer diagnosis, its treatment and prognosis, similar to other international studies. However, 60% of Maltese patients prefer a more paternalistic approach towards their physician when compared to other studies.