LEFO - Legeforskningsinstituttet

Institute for Studies of the Medical Profession

Legepanelet

Physicians` attitudes towards disclosure of prognostic information. A survey among a representative cross-section of 1605 Norwegian physicians

Rogg L, Loge JH, Aasland OG, Graugaard PK. Patient Educ Couns 2009; 77 (2): 242-7.
13. september 2009

Article in English.

Abstract on Pubmed:

OBJECTIVE: To investigate if attitudes towards disclosure of prognostic information vary by speciality, previous experience and demographic factors in a general physician population. METHODS: A postal survey among a representative sample of Norwegian physicians across all specialities (N=1605), using a translated questionnaire previously used to study attitudes towards disclosing prognostic information among US internists. RESULTS: A response rate of 70% was obtained after one reminder. 85% of the responders agreed to the helpfulness of an optimistic attitude. A factor analysis revealed three meaningful factors: `Prognostic communication is stressful`, `Fearing loss of reputation` and `Reinforcement of positive prospects`. In multivariable models significantly more female than male physicians found aspects of prognostication straining (beta=0.143, p<0.001). Those more experienced in communication of prognostic information towards end of life were less likely to support using reinforcement of positive prospects (beta=0.067, p=0.001). CONCLUSION: After years of focusing on patient autonomy and open communication between patient and physician many Norwegian physicians display attitudes that might hide the true content of prognostic information from the patients. PRACTICE IMPLICATIONS: Many physicians think they are inadequately trained in prognostication and communication of prognostic information, suggesting that increased education and training are needed if patients` wishes for information on prognosis are to be met in an individualised manner.