A Preliminary Study on the Emotional Distress of Patients with Terminal-Stage Cancer: A Questionnaire Survey of 1380 Bereaved Families over a 12-Year Period

Abstract

To clarify the emotional distress of terminal cancer patients, questionnaires were sent to 2826 families of patients who died at the National Kyushu Cancer Center; 1380 replies were obtained. Among the 1380 patients, 37.7% had been aware of the disease name and 19.8% had been unaware. Of the 1380 patients, 43.5% had prepared for and calmly accepted death, but 12.4% had greatly feared and 11.7% rejected death. Patients aware of the disease name had tended to prepare better for death but also had a stronger fear compared with those who were unaware. Patients informed of the exact nature of their disease by their physicians tended to value their remaining life more than those informed by others. Those who had desired notification of the disease name also tended to value their remaining life more than those who had not. They also spent their remaining life more usefully, and were less discouraged after being informed than those who had not expressed a wish to be informed. Thus: 1. The emotional state of the cancer patient should be clearly established before deciding to inform the patient of the true diagnosis. 2. The patient should be notified of the disease by the doctor, even if he/she is already aware of the diagnosis through others. 3. The ability to share bad news with the patient is of crucial importance for physicians when caring for terminal- stage cancer patients.