Other Management of Patient Privacy: How Physicians Navigate Disclosure of Late-Stage Cancer in China's General Hospitals.

Abstract

Research into end-of-life (EOL) communication has mostly been conducted in Anglophone countries and intensive care settings. In areas where the value of family determination prevails and significant cancer mortality rates, such as China, there remains a necessity for scholarly exploration of how EOL information about late-stage cancer diagnosis and prognosis is communicated when patients have a normal level of consciousness. Drawing on the concept of collective boundary coordination from communication privacy management (CPM) theory, this study employs semi-structured in-depth interviews to explore physicians' strategies for disclosing late-stage cancer in China's general hospitals. Reflexive thematic analysis of the data collected from seven attending physicians and nurses, 13 medical interns, and 11 family members of late-stage cancer patients demonstrates another management pattern of patient privacy and a group of flexible strategies for collective boundary coordination. These findings have implications for the development of CPM and EOL communication in China and other cultures that prioritize family determination.