Cancer patients' reluctance to disclose their emotional distress to their physicians: a study of Japanese patients with lung cancer

Purpose: To explore cancer patients' concerns about emotional disclosure (ED) to their physicians, and to investigate the factors associated with them. Subjects and Methods: Randomly selected ambulatory patients with lung cancer participated in this study. An 18-item questionnaire to assess patients' beliefs regarding ED to their physicians was developed for this study. Factor analysis was used to extract the underlying factors of this scale. Patients were asked to answer this questionnaire along with other self-administered questionnaires. Results: Complete data were available from 104 patients. Four factors were extracted by factor analysis: 'Hesitation to disturb the physicians by ED', 'No perceived need for ED', 'Negative attitude towards ED', and 'Fear of a negative impact of ED'. All factors reached standards of internal consistency. The prevalence of the above concerns, in that order, among the patients was 68, 67, 46, and 20%. Patients with high distress levels were significantly more likely to endorse 'Negative impact' (p = 0.02). Older patients were more likely to report 'Negative attitude' (p = 0.06), whereas male patients were more likely than females to report 'Hesitation' (p = 0.05). Conclusion: Knowledge of such patient-related barriers should better prepare physicians to build good communication channels with their cancer patients. Copyright (C) 2007 John Wiley & Sons, Ltd.