Lea Ungar

Family physicians' perceptions, beliefs, and attitudes regarding information sharing with prostate cancer patients throughout the course of the disease

ObjectivesThis study aimed to describe family physicians’ perceptions regarding the concerns of men with prostate cancer as well as their beliefs and attitudes toward information sharing and decision making with prostate cancer patients throughout the course of their disease.Materials and methodsA questionnaire (44 items) was mailed to 780 board-certified family physicians registered in the 2003 computerized database of Clalit Health Services, Israel’s largest health maintenance organization.ResultsThree hundred eighty-two (50%) physicians completed the questionnaires. Overall, respondents believed that patients have substantial concerns throughout the cancer trajectory and that the most troubling issue is the fear of disease progression. There were no significant differences in the amount of information physicians were willing to share with patients throughout the course of the disease. Sixty-four percent of respondents stated that they would tailor the information to the patients’ wishes and characteristics. Seventy percent felt competent at breaking bad news and 74% would discuss emotions with patients. Fifty-five percent of respondents preferred that patients be autonomous in their decision making.ConclusionsFamily physicians in Israel are aware of patients’ concerns and recognize the importance of sharing information with prostate cancer patients. Further studies are needed to examine the practice of these attitudes and to verify whether they are compatible with patients’ expectations in the relevant cultural and ethnic context.

Aspects of Fear of Personal Death, Levels of Awareness, and Professional Affiliation among Dialysis Unit Staff Members

The purpose of the present study was to examine the expressions of fear of personal death among physicians, nurses, and social workers working in dialysis units at several general hospitals. Seventy-one dialysis unit staff members and sixty-eight staff members of optomology and oto-rhino laryngology wards, who served as a control group, responded on an individual basis to: 1) Fear of Personal Death Scale [1]; 2) Four TAT cards. Results indicated no differences in fear of personal death between the two main research groups both on the conscious and on below the conscious level. When compared to social workers, physicians received lower scores of fear of personal death on both levels, and nurses scores fell between the two professions. Clear gender differences were revealed. These results and their practical implications are discussed.

Urologists' attitudes regarding information sharing with prostate cancer patients--is there a common ground for collaboration with family physicians?

Clinicians often fail to adequately meet prostate cancer patients’ information needs, and patients may receive different kinds of information from their doctors. This study aims to describe urologists’ attitudes regarding information sharing with prostate cancer patients and to compare these findings with the previously published attitudes of Israeli family physicians. A questionnaire (11 items) was mailed to 87 board-certified practicing urologists. Fifty-four physicians (66%) completed the questionnaires. Sixty-one percent of respondents stated that patients should be told the complete truth about their disease. Ninety-six percent of respondents felt competent at breaking bad news and stated they would discuss emotions with patients. The majority of physicians would provide general information when referring for a medical procedure, discussing treatment options or a patient’s prognosis. Fifty-seven percent of respondents preferred that patients be autonomous in their decision making. Only 26% of respondents believed that family physicians should communicate medical information to patients at the preliminary diagnostic stages. There was no significant difference in the attitudes expressed by urologists and family physicians towards the amount of information they would share with prostate cancer patients and in their preferences regarding treatment decision making. Urologists in Israel recognize the importance of sharing information with prostate cancer patients. Although urologists share similar attitudes with family physicians, they do not recognize the role that family physicians play in caring for prostate cancer patients. Further studies are needed to design and implement effective ways to improve the communication and collaboration between urologists and family physicians for the benefit of prostate cancer patients.