European journal of cancer care
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Eur J Cancer Care (Engl) · Sep 2010
Dying at home: community nurses' views on the impact of informal carers on cancer patients' place of death.
Giving patients with cancer a choice in where they want to die including the choice to die at home if they so wish, underpin the recent UK government policies and is embedded in the End of Life Care Programme. However, this presents increasing challenges for the informal carers particularly with an increasingly aging population. Despite the policy initiatives, there remain a persistent number of patients with cancer who had chosen to die at home being admitted to hospital in the last days and hours of life. ⋯ Data were analysed using a thematic analysis approach. The results indicated that informal carer burden was a key reason for prompting hospital admission. Recommendations for the development of a carer assessment tool with appropriate supportive interventions are made.
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Eur J Cancer Care (Engl) · Sep 2010
ReviewNot telling the truth: circumstances leading to concealment of diagnosis and prognosis from cancer patients.
While autonomy has gradually become a key concept in the doctor-patient relationship, truth-telling is far from being the norm in many countries in the world. Despite the general agreement on the benefits of open communication between physicians and cancer patients, there is still strong resistance against disclosure of cancer diagnosis and prognosis in many cultures. Although fear of causing psychological morbidity to patients and their reluctance to find out the truth are two main justifications of non-disclosure attitudes, there are other important contributing factors that need to be further explored and better understood including those related to the relatives, doctors and healthcare systems. Cultural disparities in attitudes towards truth-telling persist; however, these differences should not be used as excuses not to respect the rights and individual preferences of cancer patients by making assumptions based on their age, sex, type of cancer, language and/or cultural background.