Primary Family Caregivers' Reasons for Disclosing Versus Not Disclosing a Cancer Diagnosis in India
Primary Family Caregivers' Reasons for Disclosing Versus Not Disclosing a Cancer Diagnosis in India
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DOI：
10.1097/ncc.0000000000000669
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发表时间：
2020-03-01
期刊：
影响因子：
2.6
通讯作者：
Harris, Peter
中科院分区：
文献类型：
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作者：
Chittem, Mahati;Norman, Paul;Harris, Peter
背景：在印度，癌症诊断的保密一直是惯例，许多家庭护理人员对患者隐瞒，以保护他们免受情绪困扰。目的本研究的目的是探讨印度的主要家庭照顾者的原因，和经验，披露与不披露对患者的癌症诊断。方法8名印度家庭照护者和7名不照护者参与了半结构化访谈，探讨他们向患者披露癌症诊断的原因。采用定性内容分析对不披露的原因和不披露的原因进行分类。选择说明性引用来突出护理人员的动机，以及每个原因的经历。结果揭示了6个主要原因（情绪健康、缺乏控制、患者准备、家庭原因、患者性格、疾病的长期/可治愈性）和6个不愿透露的原因（情绪健康、家庭原因、患者性格、疾病的长期/可治愈性、沟通障碍、疾病严重程度）。通常，披露的照顾者会考虑支持和反对披露的理由，而非披露的照顾者会考虑反对披露的理由。结论：尽管对照顾者和非照顾者来说，这些原因的作用不同，但对照顾者来说，披露和不披露的大多数原因是相同的。此外，对这些原因的辩护显示出认知一致性效应，似乎减少了关于照顾者披露或不披露决定的任何不和谐感。对实践的启示癌症护士应该提供额外的心理支持，不公开的照顾者，特别是关于他们如何看待和参与他们的照顾角色。
Background Nondisclosure of cancer diagnosis continues to be practiced in India, with many family caregivers concealing it from patients in order to protect them from emotional distress.Objective The aim of this study was to explore Indian primary family caregivers' reasons for, and experiences of, disclosure versus nondisclosure to patients about their cancer diagnosis.Methods Indian disclosing (n = 8) and nondisclosing (n = 7) primary family caregivers participated in semistructured interviews exploring their reasons for disclosure versus nondisclosure of cancer diagnosis to their patient. Qualitative content analysis was used to classify the reasons for and for not disclosing. Illustrative quotes were selected to highlight caregivers' motivations for, and experiences of, each reason.Results The findings revealed 6 main reasons for disclosing (emotional well-being, lack of control, preparing the patient, family reasons, patient's personality, and longevity/curability of the disease) and 6 reasons for not disclosing (emotional well-being, family reasons, patient's personality, longevity/curability of the disease, barriers to communication, and disease severity). Typically, disclosing caregivers considered reasons for as well as against disclosure, whereas nondisclosing caregivers considered reasons against disclosure.Conclusions Most of the reasons given for disclosing and not disclosing were the same, although these reasons operated differently for disclosing and nondisclosing caregivers. In addition, justification for these reasons demonstrated cognitive consistency effects that appeared to reduce any feelings of dissonance regarding caregivers' disclosure, or nondisclosure, decisions.Implications for Practice Cancer nurses should provide additional psychological support to nondisclosing caregivers, especially with regard to how they view and engage in their caregiving role.