One-Page Truth-Telling Aid for Cancer Disclosure

Cancer-related truth-telling is an important but challenging part of oncology care. Patients may differ in how much information they want to receive, how they prefer information to be explained, who they want to be present during the discussion, and what questions or concerns they wish to raise. In routine outpatient settings, physicians often have limited time to identify these individual preferences before discussing cancer-related information.

This study will evaluate a One-Page Truth-Telling Aid designed to help physicians quickly understand patients' disclosure preferences and communication needs before the consultation. The aid is completed with patients before the visit and summarizes key information for the physician, including the patient's preferred way of receiving information, preferred communication style, desired content, and questions the patient would like to ask.

This is a two-arm, single-blind, pragmatic clinical trial. Participating physicians will be assigned to either the experimental group or the control group. Patients will be allocated according to the group assignment of their participating physician. Patients in the experimental group will complete the One-Page Truth-Telling Aid before the consultation and will be encouraged to provide it to their physician at the beginning of the visit. Patients in the control group will receive a blank sheet that they may use to write down questions before the consultation.

The study will assess patient-reported truth-telling experiences, emotional distress, and decisional regret, as well as physician-reported communication confidence. Patient assessments will be conducted before the consultation, immediately after the consultation, and at 3 and 6 months after the consultation. Physician assessments will be conducted before the intervention, 1 week after recruitment of their first enrolled patient, and at 3 and 6 months thereafter.

The study is expected to provide evidence on whether a brief, low-burden communication aid can support patient-centered truth-telling in oncology outpatient care and improve communication-related outcomes for both patients and physicians.

【Physicians】

• Inclusion Criteria:

• Physicians who provide clinical care for patients with cancer in participating outpatient departments.
• Physicians who are involved in cancer-related truth-telling or disclosure consultations.
• Physicians who are willing to participate and provide informed consent.
• Exclusion Criteria:

• Physicians who are unable or unwilling to complete study procedures or follow-up assessments.

【Patients】

• Inclusion Criteria:

• Patients diagnosed with cancer.
• Patients who are scheduled to receive cancer-related information from a participating physician, including information about diagnosis, recurrence, metastasis, end-of-life status.
• Patients who are able to communicate in Mandarin Chinese or Taiwanese.
• Patients who are able to complete questionnaires independently or with assistance from the research assistant.
• Patients who are willing to participate and provide informed consent.
• Exclusion Criteria:

• Patients who are unable to provide informed consent.
• Patients with severe cognitive impairment, severe physical illness, or emotional distress that prevents participation, as judged by the clinical team or research staff.
• Patients who are unable to complete the study questionnaires even with assistance.