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Background: Decisions around disclosure of a diagnosis of dementia are not always patient-centred; a plethora of literature supports the notion that physicians do not always clearly and directly disclose the diagnosis to the person with dementia. Aim: To conduct a thematic review of the literature in relation to the effects of disclosing a dementia diagnosis to the person with dementia. Method: The literature was searched between February 2013 and June 2013. To enable detailed appraisal and analysis, only studies conducted from 2006 onwards were reviewed. Results: The perceived negative impacts of disclosure, i.e. depression and suicidal tendencies, were not as common as the background literature suggests. Disclosure had many positive outcomes, for example in terms of future planning and the 'relief' that a recognised disease was the cause of the symptoms as opposed to 'old age'. Discussion: The person with dementia has a right to disclosure in all instances, even if to decline a formal diagnosis. Through omission of a clear diagnosis, the person is disempowered. A clear diagnostic framework is absent. Diagnosis should take place over multiple sessions, not only to facilitate coping but also for practical reasons, for example to allow adequate recall. [ABSTRACT FROM AUTHOR]

Background and Objective: Disclosure of cancer is one the main challenges in caring of patients with cancer, since it may have adverse effects on the patients quality of life. This study was done to determine life quality of cancer patient with or without self awareness. Materials and Methods: This case - control study was conducted on 300 cancer patients in Shahid Ghazi-Tabatabaei hospital in Tabriz, Iran during 2009. The cancer patients included 150 subjects aware of their cancer diagnosis as cases and 150 unaware patients as controls. The patient's quality of life was assessed Using EORTC QLQ-C30 questionnaire. Data were analyzed using SPSS-17 and student's t-test. Results: The mean±SD of quality of life among aware and unaware patients were 64.18±18.85 and 65.16±19.02, respectively. There was no significant difference of quality of life between two groups. Life social dimension in unaware patients significantly was more than aware patients (P<0.05). Conclusion: Patients awareness of cancer have no effect on their quality of life. [ABSTRACT FROM AUTHOR]

Background: There have been few studies investigating neuro-oncologists' attitudes toward the disclosure of the diagnosis. This study aimed to determine the current status of disclosure to glioma patients in Japan and to analyze the factors associated with disclosure. Methods: A set of questionnaires about disclosure to patients with malignant glioma was distributed by e-mail to 191 physicians participating in the 27th Annual Meeting of the Japan Society for Neuro-Oncology. Results: The response rate was 73.8% (141/191). Of these, 44.3% disclosed the correct diagnosis to glioblastoma patients aged <60 years and 41.4% disclosed the correct diagnosis to those aged ≥70 years; for anaplastic astrocytoma patients, these proportions were 61.5 and 51.9%, respectively. Physicians working at facilities performing surgery on more than 50 cases of glioma per year, those in metropolitan areas, and those with other patient psychosocial support systems available disclosed the diagnosis and prognosis more frequently. The physicians' gender and postgraduate period of practice did not influence disclosure. When the family opposed disclosing the diagnosis to the patient, more than half of the physicians respected the family's wishes. Conclusions: This survey revealed that most of the physicians told at least the malignant nature of the disease to patients with malignant glioma, but they did not always tell the exact diagnosis. Physicians tended to modify their attitudes toward disclosing a diagnosis or prognosis of glioma depending on the histopathological grading, the hospital volume of cases, the location, the availability of patient psychological support systems, and the patient's family's wishes. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences of diagnosis disclosure of the cancer patients, in order to understand the current practice of cancer diagnosis telling and the feeling of the patients being disclosed. Method: Qualitative approach was adopted by conducting in-depth interview with 10 cancer patients who were purposely selected in a Cancer Therapeutic Center, to collect information on their experiences of being told the diagnosis. Results: Content Analysis was used to conclude and identify two main themes out of the 10 interviews. They are (1) Way of disclosing cancer diagnosis - includes target and content of disclosure. (2) Experiences of cancer patients after being disclosed the diagnosis - includes emotional disorder, calmness, struggling in the heart, support from family and society and formulation of positive thinking. Discussion and Conclusion: Interviewees experience extra anxiety and helplessness because they had not been told about the details of their disease and had not been given chance to express their feeling. This highlights the necessity of reviewing the way and content of cancer diagnosis telling. Cancer patients undergo more complicated struggling and suffering in the heart than how they behave, while can be well relieved by the support of spouse, peer patients and religious groups. This reminds that healthcare professionals can play an important role to encourage and involve these people in caring for cancer patients. [ABSTRACT FROM AUTHOR]

Background Although there is extensive research examining parental experiences of assessment and diagnosis of autism, there is a paucity of research from the perspective of individuals with autism. Method Semi-structured interviews were conducted with nine young people with high functioning autism who were capable of providing a verbal account of their perceptions of autism and diagnosis experiences. Data were analysed using interpretative phenomenological analysis. Results Diagnosis, and the disclosure of the diagnosis of autism, were embedded in respondents' perceptions of “having” autism. This superordinate theme included five themes: (i) disclosure delay, (ii) providing explanations, (iii) potential effects of labelling, (iv) disruptions and opportunities, and (v) acceptance and avoidance. Conclusion In relation to the existing literature, it is suggested that the effects of diagnosis, or disclosure of diagnosis, from the perspective of the person with autism be given greater consideration. [ABSTRACT FROM AUTHOR]

Background: There is little, though growing, interest in the research area of attitudes held among physicians towards disclosing the diagnosis of dementia and Alzheimer's disease (AD), or the current practice on AD disclosure. This study aimed to investigate the practice and attitudes of specialized physicians towards AD diagnosis disclosure in Brazil. Methods: A questionnaire was devised to survey the current practice and attitudes regarding diagnosis disclosure of AD in Brazil and sent to specialized physicians (170 geriatricians, 300 neurologists and 500 psychiatrists) by electronic mail. Results: From 970 potential respondents, 181 physicians who usually attend AD patients returned the questionnaire. There were no significant differences between the three specialties regarding the frequency with which they informed patients of their AD diagnosis (p = 0.17). The results revealed that only 44.8% of the physicians would regularly inform the patient of the diagnosis, although 85.6% of these use clear terminology. Despite their usual practice, 76.8% would want to know their diagnosis if they themselves were affected by AD. Conclusions: Disclosure of AD diagnosis is not common among specialized physicians in Brazil and different factors are involved. In the clinical context, discussion on advantages of diagnosis disclosure can be useful for improving the care of AD patients and their families. [ABSTRACT FROM AUTHOR]

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Abstract: Objective: To enhance the understanding and effect of physician''s difficulties, attitudes and communication styles on the disclosure of the diagnosis of AD in practice. Methods: Qualitative, phenomenological study, combining pre-encounter interviews with physicians, observations of actual encounters of diagnosis disclosure of AD, and post-encounter interviews. Results: There were various ways or tactics to (un)veil the bad news that may be perceived as different ways of dulling the impact and avoiding full and therefore problematic statements. In the actual encounters this was accomplished by keeping encounters short, avoiding elaboration, confirmation of comprehension and explicit terminology and using fractured sentences. Conclusion: The present study''s findings highlight the difficulties encountered in breaking the news about AD, in the way it is actually done, and the problems that may arise from this way of un/veiling the news. The main problem is that the reluctance to make a candid disclosure of the diagnosis as was demonstrated in this study may violate basic moral and legal rights and may also deprive patients and caregivers of some of the benefits of early disclosure of diagnosis. Practice implications: There is a need for assisting physicians to cope with their personal difficulties, problems and pitfalls in breaking the news. [Copyright &y& Elsevier]

Cancer diagnosis disclosure represents a particular challenge for radiologists because they cannot offer therapeutic strategies that can ease acceptance. Transparency in providing information, which is stipulated by law, means communicating the details of medical imaging. Radiologists must, nonetheless, disclose results with sensitivity, taking into account ethical issues regarding the impact the disclosure. [ABSTRACT FROM AUTHOR]

The article discusses several studies about Alzheimer's disease (AD) management that aims to maximize the functional ability of the patient throughout the continuum of the disease by providing relevant benefits in the key clinical domains of activities of daily living, behavior, and cognition. These studies were conducted in various countries such as Great Britain and Japan.

Abstract: Background: The current study sought to determine effective methods for disclosing breast cancer diagnosis and to identify epidemiologic patterns in patient preference for method of information disclosure. Methods: Surveys were sent to 691 breast cancer patients over 10 years. Questions evaluated the best methods for telling a woman of her diagnosis. The chi-square, Wilcoxon rank, and Mantel-Haenszel tests were used for statistical associations. Results: Ninety percent of patients had no preference for which gender disclosed the diagnosis. Fifty-nine percent said they believe it is important to be asked how much information one would like to know when initially told the diagnosis. However, most (54%) were not asked when they were told. When asked if previous ideas about breast cancer influenced their concerns, 79% answered “yes” or “somewhat.” However, only 10% knew “a great deal.” Conclusions: Patients have defined preferences about breast cancer diagnosis disclosure, making effective methods of diagnosis disclosure important to identify and practice. [Copyright &y& Elsevier]

Abstract: As children living with human immunodeficiency virus (HIV) survive into adolescence and young adulthood, attention to the relationship of diagnosis disclosure to psychological functioning, interpersonal relationships, and HIV prevention is needed. This exploratory study describes the level of adolescents’ diagnosis disclosure to family, friends, and potential sexual partners, and the relationship between disclosure and psychosocial variables. [Copyright &y& Elsevier]

Context The question of how best to disclose to patients the diagnosis of serious and/or incurable neurological diseases has been much explored, but that of when has received little rigorous study. The present study investigates this question in relation to multiple sclerosis (MS), a disease marked by its incurability, unpredictability and predilection for young adults. Objectives We aimed to ascertain the preferences of Greek MS sufferers concerning when they should ideally be informed they have the disease, and their preferences and reactions regarding disclosure of the diagnosis. Design, setting and patients 1200 Greek MS patients, members of the MS Society, were asked to complete a questionnaire regarding their experience of and attitudes towards receiving the diagnosis. Results 657 patients (55 %) responded. 91% favoured learning the diagnosis immediately, but only 44% had had this experience: 29% had been informed within 1–3 years, and 27% later. Interestingly, however, a significant minority (9%) suggested a possible preference for delayed delivery of diagnosis and 23.2% stated that concealing the diagnosis would not lead to loss of confidence in their doctor. Conclusion This study - the largest of its kind - provides objective data supporting prompt disclosure of diagnosis as the clearly-expressed preference amongst most patients. Interestingly, however, the results also reemphasise the importance of a difficult medical art: attempting to judge whether an individual patient is one (of the 91%) preferring immediate disclosure - or of the nearly 1-in-10 (9%) who may not. [ABSTRACT FROM AUTHOR]

The most common sex chromosome aneuploidies (SCA) (47, XXY; 47, XYY; 47, XXX) frequently result in a milder phenotype than autosomal aneuploidies. Nevertheless, these conditions are highly variable and more symptomatic phenotypes may require significant clinical involvement, including specialty care. While historically most individuals with mild phenotypes remained undiagnosed during their lifetime, the increasing use of genetic testing in clinical care has increased the prenatal and postnatal diagnosis of SCAs. These genetic tests are frequently ordered by nongenetic providers who are also responsible for delivering the diagnosis. We surveyed parents of children (n = 308) to evaluate their experience of receiving a diagnosis and their support needs. The majority (73.3%) received the diagnosis from a nongenetic medical provider. Following a prenatal diagnosis parents reported experiencing depression, anxiety, and less optimism than those receiving a postnatal diagnosis. Few parents reported receiving materials explaining their child's condition that they found to be up-to-date, accurate, and unbiased. The frequently negative reported experiences of parents at time of diagnosis suggests more educational opportunities should be provided for nongenetic providers in order to become more informed about these conditions and communicate the diagnosis in a way parents experience as supportive., (© 2020 Wiley Periodicals, Inc.)

• Behavioural manifestations may diminish the perceived credibility of autistic witnesses. • However, the present study found that autistic witnesses were rated as credible as typically developing (TD) witnesses. • Further, informing mock jurors when a witness is autistic and providing them with further information about autism improved their credibility ratings. • In fact, diagnosis disclosure resulted autistic witnesses being rated as slightly more credible than TD witnesses. People with autism spectrum disorder (henceforth, autism) exhibit a number of atypical behaviours that may be relied upon by jurors when making judgements about their credibility as witnesses. The current study aimed to: (1) examine whether autistic witnesses were perceived as less credible than typically developing (TD) witnesses, irrespective of the number of correct details they reported; and (2) determine whether mock jurors' credibility ratings of autistic witnesses improved if they were aware of their autism diagnoses and were provided with information about autism. One-hundred-and-twenty-five mock jurors rated the credibility of video testimony of 17 autistic and 17 TD witness participants recalling an event. Half of the juror participants were informed that some of the witnesses were autistic and were provided with information about autism; the other half received no information about witnesses' diagnoses. Contrary to predictions, autistic witnesses were seen to be as credible as TD witnesses when no information about their diagnosis was provided. However, when jurors were informed that a witness was autistic and were also provided with further information about autism, they were rated as slightly more credible than TD witnesses. Credibility ratings were only predicted by jurors' prior knowledge/experience of autism when they were explicitly informed of witnesses' autism diagnoses. These results indicate that disclosing one's autism diagnosis (alongside further information about autism) may result in a positive bias in terms of witnesses' perceived credibility. Implications for jury instructions and future research directions are discussed. [ABSTRACT FROM AUTHOR]

Background: Recently the dementia field has shifted focus away from the early diagnosis debate in favour of 'timely' diagnosis. 'Timely' diagnosis disclosure takes into consideration the preferences and unique circumstances of the individual. Determining when diagnosis disclosure is 'timely' may be particularly complex if there are differing views between the individual, their family, and their health care providers regarding disclosure. This study explores the preferences of consumers regarding when a diagnosis of dementia should be communicated.Methods: A cross-sectional survey was conducted with English-speaking adults attending outpatient clinics at an Australian hospital. Participants were recruited by a research assistant in the clinic waiting room and invited to complete the survey on a web-connected iPad. The survey included questions examining socio-demographics and experience with dementia. Two scenarios were used to explore preferences for timing of diagnosis disclosure.Results: Of 446 participants, 92% preferred a diagnosis of dementia to be disclosed as soon as possible. Preferences were not associated with socio-demographics or previous dementia experience. Most participants also preferred disclosure to occur as soon as possible if their spouse or partner was diagnosed with dementia (88%). There was strong correlation between preferences for self and preferences for spouse (0.91).Conclusions: These findings provide guidance to health care providers about preferences for disclosure of a dementia diagnosis, and may help to overcome potential barriers to timely diagnosis. As the prevalence of dementia increases, consumers' preference for diagnosis to occur as soon as possible has important implications for the health system. [ABSTRACT FROM AUTHOR]

Abstract Although growing, the literature on research into attitudes of general and specialized physicians towards disclosing the diagnosis of dementia and Alzheimer's disease (AD), or the current practice on AD disclosure, remains limited. Moreover, information is also scarce on what caregivers, or indeed patients themselves, wish to know with regard to their diagnosis. The goal of the present article was to present a review of the current available literature on the topic of truth telling in dementia, especially in AD. The studies discussed in this review were mainly conducted in Europe, particularly in the United Kingdom, as well as the United States. Disclosure of AD diagnosis is not a common practice among physicians. In the clinical context, the discussion on diagnosis disclosure can be valuable for improving the care of AD patients and their families.

The implementation of cross-functional measures along the care pathway of cancer patients in France is globally lower in the elderly. However, age is not a criterion for excluding curative treatment, and the evaluation of physical, psychological and social resources and comorbidities is particularly significant in this population. Identifying needs in terms of support care which influences the patient's quality of life as well as the efficacy of treatments is also essential. The objective of geriatric oncology coordination is to offer elderly cancer patients global treatment, curative or otherwise, through the putting in place of a personalised care programme., (Copyright © 2019. Published by Elsevier Masson SAS.)

Highlights: Breaking bad news is still deemed a difficult task by family physicians.Family physicians feel they need training in breaking bad news.The family physicians' attitude to this issue is different from what they would wish if they themselves had a life-threatening disease., Background: Family practice is the specialty with the highest number of doctors and covers all of Portugal. Therefore, the attitude of these doctors may have a high impact on patients., Objective: To explore the opinion and difficulties of Portuguese family doctors on dealing with communication with patients with life threatening diseases., Methods: A questionnaire was sent to about 10% of family doctors of Northern Portugal. The questionnaire included questions about the disclosure of information, if they feel they need training courses and what they would want if they had a life-threatening disease., Results: A questionnaire was given to 196 doctors and 159 (81%) participated in this study. The median age was 43 years (26-64) and 108 (68%) were females. One hundred thirty-five (85%) consider that breaking bad news is a difficult task. One hundred twenty-four (78%) feel they need training in breaking bad news. For many doctors, the disclosure of diagnoses and prognoses has a detrimental psychological effect and affects patients' hope, but gives patients' control of the situation. Given a situation where the doctors themselves had a life-threatening disease, the vast majority would want to know the diagnosis and the prognosis and to participate in treatment decisions., Conclusions: Breaking bad news is still a difficult task. Their attitude to this duty is different from what they would wish if they themselves had a life-threatening disease. One important conclusion is the need of specific training in communication for family physicians that should begin in the training phase of their specialty., Competing Interests: The authors declare no conflicts of interest., (Copyright 2017 PBJ-Associação Porto Biomedical/Porto Biomedical Society.)

Highlights: The attitudes of family physicians regarding breaking bad news are heterogeneous.Younger doctors seem to see the delivery of bad news more positively.This trend suggests that there will be a more open communication in the future., Background: Family practice is the specialty with the highest number of doctors and covers all of Portugal, but, as far as we know, no studies have been carried out on the attitudes and practices of Portuguese family practice doctors about breaking bad news. However, the attitude of these doctors may have a high impact on patients., Objective: To study the practice of family physicians on breaking bad news., Methods: A questionnaire, specifically developed for this survey, was given to 196 doctors about 10% of the family physicians of Northern Portugal., Results: One hundred fifty-nine (81%) of them participated in this study. The median age was 43 (26-64) and 108 (68%) of them were female. One hundred and seven (67%) doctors disclosed on principle the diagnosis and that rate rose to 81% when patients requested the disclosure. One hundred and two (64%) proactively questioned patients about their wish to know the diagnosis and then decided whether to convey it or not. Forty-seven 47 (30%) doctors disclosed the prognosis on principle and that rate rose to 48% when patients requested the disclosure. Seventy-three (46%) often questioned patients proactively about their wish to know the prognosis and then decided whether to convey it or not. One hundred and two (64%) doctors frequently include patients in treatment decisions. Physicians think that the disclosure may affect hope but may also give patients more control of the situation., Conclusion: Family practitioners disclose the diagnosis of a chronic life-threatening disease often, especially at patients' request. General practitioners do not disclose the prognosis of a life-threatening disease often, even at patients' request., Competing Interests: The authors declare no conflicts of interest., (Copyright 2017 PBJ-Associação Porto Biomedical/Porto Biomedical Society.)

Vascular dementia (VaD) is the most prevalent form of secondary dementia and the second most common of all dementias. The present paper aims to define guidelines on the basic principles for treating patients with suspected VaD (and vascular cognitive impairment - no dementia) using an evidence-based approach. The material was retrieved and selected from searches of databases (Medline, Scielo, Lilacs), preferentially from the last 15 years, to propose a systematic way to assess cognition, function and behavior, and disease severity staging, with instruments adapted for our milieu, and diagnosis disclosure. The present proposal contributes to the definition of standard diagnostic criteria for VaD based on various levels of evidence. It is noteworthy that only around half of the population of patients with vascular cognitive impairment present with dementia, which calls for future proposals defining diagnostic criteria and procedures for this condition., Competing Interests: Disclosure: The authors report no conflits of interest.