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Primary Family Caregivers' Reasons for Disclosing Versus Not Disclosing a Cancer Diagnosis in India

Chittem, Mahati, PhD; Norman, Paul, PhD; Harris, Peter, PhD

doi: 10.1097/NCC.0000000000000669
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Background Nondisclosure of cancer diagnosis continues to be practiced in India, with many family caregivers concealing it from patients in order to protect them from emotional distress.

Objective The aim of this study was to explore Indian primary family caregivers' reasons for, and experiences of, disclosure versus nondisclosure to patients about their cancer diagnosis.

Methods Indian disclosing (n = 8) and nondisclosing (n = 7) primary family caregivers participated in semistructured interviews exploring their reasons for disclosure versus nondisclosure of cancer diagnosis to their patient. Qualitative content analysis was used to classify the reasons for and for not disclosing. Illustrative quotes were selected to highlight caregivers' motivations for, and experiences of, each reason.

Results The findings revealed 6 main reasons for disclosing (emotional well-being, lack of control, preparing the patient, family reasons, patient's personality, and longevity/curability of the disease) and 6 reasons for not disclosing (emotional well-being, family reasons, patient's personality, longevity/curability of the disease, barriers to communication, and disease severity). Typically, disclosing caregivers considered reasons for as well as against disclosure, whereas nondisclosing caregivers considered reasons against disclosure.

Conclusions Most of the reasons given for disclosing and not disclosing were the same, although these reasons operated differently for disclosing and nondisclosing caregivers. In addition, justification for these reasons demonstrated cognitive consistency effects that appeared to reduce any feelings of dissonance regarding caregivers' disclosure, or nondisclosure, decisions.

Implications for Practice Cancer nurses should provide additional psychological support to nondisclosing caregivers, especially with regard to how they view and engage in their caregiving role.

Author Affiliations: Department of Liberal Arts, Indian Institute of Technology Hyderabad, Hyderabad, India (Dr Chittem); and Department of Psychology, University of Sheffield (Dr Norman); and Department of Psychology, University of Sussex (Dr Harris), United Kingdom.

Correspondence: Mahati Chittem, PhD, Department of Liberal Arts, Indian Institute of Technology Hyderabad, Kandi, Sangareddy District, Telangana 502285, India (mahati@iith.ac.in).

This research work was funded through a PhD fellowship awarded to the first author, M.C., by the University of Sheffield, United Kingdom, doctoral studentship.

The authors have no funding or conflicts of interest to disclose.

Accepted for publication September 12, 2018.

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