Nondisclosure and the Impact on Symptom Burden in Muslims With Advanced Cancer: A Review of Five Symptom Assessment Tools

Abstract

Cultural and religious beliefs in certain regions, including many Muslim-majority countries, often lead families to request the withholding of medical information from patients. Despite the availability of validated symptom assessment tools for chronic conditions such as cancer, chronic obstructive pulmonary disease, neurological disorders, heart disease, and renal failure, the effect of nondisclosure on symptom burden remains insufficiently explored. This scoping review examines the role of symptom assessment tools in evaluating the outcomes of nondisclosure in advanced cancer patients, particularly in the United Arab Emirates (UAE). The review assesses five key instruments: the Edmonton Symptom Assessment Scale (ESAS), its revised version (ESAS-r), the Memorial Symptom Assessment Scale (MSAS), the short form (MSAS-SF), and the Palliative Care Outcome Scale (POS). An analysis of the psychometric properties, strengths, and limitations of these tools highlights their utility in understanding symptom burden and psychological well-being. The findings suggest that comprehensive tools like the MSAS provide valuable assessments but require further validation to confirm their effectiveness across diverse clinical and cultural settings. Future research should prioritize adapting these tools for wider application and ensuring their reliability and validity in measuring the impact of nondisclosure on symptom burden across various diagnoses, including both cancer and noncancer conditions.