Attitudes of cancer patients and their families toward disclosure of cancer diagnosis in Saudi Arabia: a Middle Eastern population example

Figures & data

Table 1 The characteristics of the subjects

Characteristics	Patient group, N=304	Family group, N=277	P -value
Age			<0.001
Mean	48.3	36.51
SD	15.3	12.5
Gender			<0.001
Male	114 (37.6%)	129 (53.1%)
Female	189 (62.4%)	114 (46.9%)
Education			<0.001
Did not complete high school	152 (50.2%)	59 (24.3%)
Completed high school	151 (49.8%)	184 (75.7%)
Employment			<0.001
Employed	63 (20.8%)	108 (44.4%)
Unemployed	240 (79.2%)	135 (55.6%)
Relation to patient			<0.001
Father	–	10 (5.6%)
Mother	–	22 (12.4%)
Husband or wife	–	32 (18.1%)
Son or daughter	–	74 (41.8%)
Brother or sister	–	21 (11.9%)
Other	–	18 (10.2%)
Time of knowing the diagnosis
Before treatment	245 (86.27%)	–
During treatment	27 (9.51%)	–
After treatment	12 (4.23%)	–
Type of cancer
Breast cancer	68 (22.4%)	–
Lymphoid cancer	56 (18.4%)	–
Gastrointestinal cancer	64 (21.1%)	–
Genitourinary cancer	31 (10.2%)	–
Lung cancer	16 (5.26%)	–
Central nervous system cancer	9 (2.96%)	–
Thyroid cancer	7 (2.30%)	–
Other types	32 (10.5%)	–
Patient does not know	21 (6.91%)	–
Stage of cancer
Metastasized	57 (19.86%)	–
Not metastasized	163 (56.79%)	–
Patient does not know	67 (23.34%)	–

Figure 1 The percentage of participants who answered “yes” to the following questions: (A) Do you think a patient should be informed about cancer diagnosis? (B) Do you think a patient should be given all the details of his cancer status? (C) When do you think a patient should be informed about cancer? *P<0.05; **P<0.001.

Table 2 Differences in attitudes toward disclosure of cancer diagnosis

Factors that help patient in accepting cancer diagnosis	Patient n=304	Family member n=277	P-value
Support from family and friends	257 (85.1%)	209 (90.5%)	0.06
Relationship between the doctor and the patient	264 (87.4%)	206 (89.2%)	0.53
Relationship between the nursing staff and the patient	220 (72.8%)	166 (71.9%)	0.80
Religion	277 (91.7%)	211 (91.3%)	0.87
Quality of health care	230 (76.2%)	182 (78.8%)	0.47
Location of treatment	210 (69.5%)	167 (72.3%)	0.48
Knowing that the patient will be cured	219 (72.5%)	177 (76.6%)	0.28
Reasons for cancer disclosure	Patient n=241	Family member n=170
To better organize remaining life	169 (70.1%)	121 (71.1%)	0.81
To help in treatment course	181 (75.1%)	132 (77.6%)	0.55
To improve family relationships	59 (24.4%)	55 (32.3%)	0.79
To avoid living under an illusion	100 (41.4%)	83 (48.8%)	0.14
To get several medical advices	58 (24%)	52 (30.5%)	0.14
Reasons for cancer nondisclosure	Patient n=55	Family member n=48
To prevent a negative effect on the patient	37 (67.2%)	37 (77%)	0.59
To avoid change in daily life	9 (16.3%)	11 (22.9%)	0.56
To avoid pity from others	22 (40%)	22 (45.8%)	0.31
No treatment for cancer	3 (5.4%)	8 (16.6%)	0.10
What is the possibility to recover from cancer?
<50%	37 (12.6%)	56 (24.6%)	0.00a
>50%	256 (87.4%)	172 (75.4%)
Patient’s reaction to disclosure of cancer
Denial	12 (4%)	14 (6%)	0.27
Fear	169 (56.3%)	162 (70.4%)	0.00a
Anger	10 (3.3%)	10 (4.5%)	0.54
Confusion	35 (11.6%)	38 (16.5%)	0.10
Acceptance	114 (38%)	35 (15.2%)	0.00a
Sadness	72 (24%)	65 (28.2%)	0.26

Note:

a P<0.001.

Table 3 Binary logistic regression analysis predicting disclosure of cancer

Variable	Do you think a patient should be informed about cancer diagnosis? (yes)		Do you think a patient should be given all the details of his cancer status? (yes)		When do you think a patient should be informed about cancer? (before treatment)
	OR	95% CI	OR	95% CI	OR	95% CI
Group
Family	1		1a		1b
Patient	1.38	0.88–2.15	3.26	2.11–5.05	1.59	1.05–2.41
Gender
Female	1		1		1
Male	0.63	0.39–1.00	0.85	0.54–1.36	0.69	0.44–1.07
Age
50 and older	1		1		1
Younger than 50	1.42	0.85–2.38	1.46	0.88–2.42	1.26	0.78–2.01
Education
Lower than high school	1		1		1
Higher than high school	1.23	0.71–2.11	1.20	0.70–2.04	1.21	0.73–2.01
Cancer information
Not having information about cancer	1b		1		1a
Having information about cancer	1.80	1.15–2.84	1.48	0.95–2.29	1.93	1.27–2.94
Employment
Not employed	1b		1		1a
Employed	1.77	1.00–2.82	1.64	0.98–2.76	2.08	1.25–3.44

Notes:

a P<0.001;

b P<0.05.

Abbreviations: CI, confidence interval; OR, odds ratio.