Psychological and social impact of announcing cancer diagnosis in a Moroccan university hospital oncology unit: a cross-sectional study
摘要
The manner in which a cancer diagnosis is communicated is closely associated with patients’ adherence to treatment, quality of life, risk of complications, and prognosis. In Morocco, however, systemic and cultural barriers persist, rendering the process of disclosing a cancer diagnosis fragmented and emotionally challenging for many patients.
MethodsA cross-sectional study was conducted involving 100 cancer patients receiving treatment at Ibn Rochd University Hospital between October 2023 and January 2024. Participants completed a socio-demographic and medical history questionnaire. Psychological distress was assessed using the Hospital Anxiety and Depression Scale (HADS), and perceived social support was evaluated via the Multidimensional Scale of Perceived Social Support (MSPSS).
ResultsThe mean age of participants was 57.8 years, with a predominance of female patients (63%). The most prevalent cancer types were breast cancer (40%), lung cancer (19%), and digestive tract tumours (19%). Most patients (78%) were diagnosed at non-metastatic stages, while 22% presented with metastatic disease.
Regarding diagnostic disclosure practices, 95% of patients were informed of their diagnosis during face-to-face consultations. Thirty-eight per cent required more than three consultations to fully comprehend their diagnosis. While 74% reported that their physician employed clear and appropriate language, 79% felt that healthcare professionals did not adequately attend to their concerns.
In relation to treatment discussions, 79% stated that they had sufficient time to deliberate over their care plans. Nevertheless, 85% believed that the proposed treatment did not meet their expectations.
From a psychological perspective, 60% of patients exhibited clinically significant symptoms of anxiety, and 53% displayed signs of depression. Levels of perceived social support were reported as moderate (72%), high (25%), or low (3%).
ConclusionThese findings indicate notable gaps in the current approach to the disclosure of cancer diagnoses in Morocco. Although the cross-sectional design precludes causal inference, the observed associations highlight the potential value of implementing a structured, patient-centred, four-step protocol for diagnosis disclosure. Such a protocol should emphasise clear and empathetic communication, ensure patient understanding, and provide sufficient emotional and informational support throughout the consultation process.