Cancer by another name: a randomized trial of the effects of euphemism and uncertainty in communicating with cancer patients.

作者：Stewart M. Dunn, Pandora Patterson, Phyllis Noemi Butow, H H Smartt, W. H. McCarthy, Martin H.N. Tattersall · 发表于：Journal of Clinical Oncology · 年份：1993 · DOI：10.1200/jco.1993.11.5.989 · 被引用次数：97 · 研究领域：Swearing, Euphemism, Multilingualism、Patient-Provider Communication in Healthcare、Health Literacy and Information Accessibility

PURPOSE: In this study we tested some assumptions about the use of euphemism in communicating with cancer patients. Does an explicit statement about the diagnosis of cancer cause patients to respond with greater anxiety than when uncertainty or ambiguity is allowed to persist? Do patients believe they cope better with cancer when the diagnosis is explicit? METHODS: A heterogeneous sample of 165 cancer patients completed a new measure of emotional adjustment to cancer using random assignment among four testing variables: agent (self-report v interview), terminology (the words cancer v illness), identification (patient identified v anonymous), and supervision (clinic v home). Internal consistency (Cronbach's alpha) for the 39-item set was 0.74 and face and content validity were determined using the focus-group technique and preliminary factor analysis. After answering the adjustment measures, subjects completed the Spielberger State-Trait Anxiety Inventory (STAI). RESULTS: Overall anxiety levels were significantly lower in the sample than published norms for general medical and surgical patients. Exposure to the word cancer as distinct from illness increased anxiety, but did not alter adjustment scores. Supervision and agent conditions did not affect anxiety, but reported adjustment was poorer in the interview condition compared with the self-report condition. Ambiguous instructions, such as asking patients to complete the questionnaire anonymously but return it in person to st...