J Korean Med Sci.  2018 Dec;33(49):e327. 10.3346/jkms.2018.33.e327.

Discordance between Physician and the General Public Perceptions of Prognostic Disclosure to Children with Serious Illness: a Korean Nationwide Study

Affiliations
  • 1Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
  • 2Department of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Korea. lawyun@snu.ac.kr
  • 3Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea.
  • 4Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 5Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
  • 6Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 7Department of Hemato-Oncology, Daegu Fatima Hospital, Daegu, Korea.
  • 8Division of Hematology and Oncology, Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
  • 9Department of Internal Medicine, Gyeongsang National University, Jinju, Korea.
  • 10Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.
  • 11Department of Medical Oncology and Hematology, Kyung Hee University Hospital, Seoul, Korea.
  • 12Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.
  • 13Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 14Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
It is difficult to decide whether to inform the child of the incurable illness. We investigated attitudes of the general population and physicians toward prognosis disclosure to children and associated factors in Korea.
METHODS
Physicians working in one of 13 university hospitals or the National Cancer Center and members of the general public responded to the questionnaire. The questionnaire consisted of the age appropriate for informing children about the prognosis and the reason why children should not be informed. This survey was conducted as part of research to identify perceptions of physicians and general public on the end-of-life care in Korea.
RESULTS
A total of 928 physicians and 1,241 members of the general public in Korea completed the questionnaire. Whereas 92.7% of physicians said that children should be informed of their incurable illness, only 50.7% of the general population agreed. Physicians were also more likely to think that younger children should know about their poor prognosis compared with the general population. Physicians who opposed incurable illness disclosure suggested that children might not understand the situation, whereas the general public was primarily concerned that disclosure would exacerbate the disease. Physicians who were women or religious were more likely to want to inform children of their poor prognosis. In the general population, gender, education, comorbidity, and caregiver experience were related to attitude toward poor prognosis disclosure to children.
CONCLUSION
Our findings indicate that physicians and the general public in Korea differ in their perceptions about informing children of poor prognosis.

Keyword

Pediatric Palliative Care; Prognostic Disclosure to Children; Pediatric Advance Care Planning; Republic of Korea

MeSH Terms

Caregivers
Child*
Comorbidity
Disclosure*
Education
Female
Hospitals, University
Humans
Korea
Prognosis
Republic of Korea
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