Exploring nursing advocacy in relation to truth telling in cancer care: a literature review




Rastgou-Dastjerdi, Laleh

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Truth telling in cancer care is a complex and challenging issue for families and health professionals. Sometimes patients’ needs for knowing the truth about diagnosis or prognosis are undermined by families’ requests of non-disclosure and by the dominant ideologies held by the professionals working within the health care system. Such cases present unique challenges for nurses and raise questions about the advocacy role in nursing. In this paper, I have reviewed 52 nursing research and theoretical articles, book chapters, and nursing practice guidelines to explore the concept of nursing advocacy in truth telling to cancer patients about their diagnosis and prognosis. I have examined the relevance of nursing advocacy in truth telling, the context in which truth telling should occur, and explored the factors that would support or hinder advocacy in truth telling to cancer patients. Advocacy in truth telling means providing patients with access to the information in relation to diagnosis and prognosis based on patients’ needs and desires. The literature reviewed for this paper and the nursing standards of practice and Code of Ethics provide strong support for advocacy in truth telling as part of the nursing role and within the scope of practice. Nevertheless, collaboration between nurses and other health professionals would enhance nurses’ abilities to advocate for patients’ needs for information. These needs should be assessed on continuous bases and information should be provided based on patients’ expressed needs and wishes. From an analysis of the literature reviewed both some supporting and hindering factors that would affect nurses’ abilities or willingness with regards to advocacy actions are discussed. Following the analysis, I offer some recommendations for nursing education, research, and creation of strategies in the areas of practice and policy making. As part of the recommendations for practice, I present a preliminary assessment tool that can be used for evaluating patients’ needs for information and conditions that can affect provision of that information (Appendix A).



nursing advocacy, relation, truth telling, cancer care, literature review