Denial and communication

Linda Sheahan, David W. Kissane

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Otherpeer-review

Abstract

Patients who appear not to acknowledge the diagnosis of an illness, or its gravity, are said to be 'in denial'. A patient's history readily illustrates this in Box 16.1.

Denial is considered a common reaction, especially when an illness is life-threatening. After being told of the diagnosis of terminal cancer, approximately 20% of patients deny they have cancer, 26% partially suppress awareness of impending death, and 8% demonstrate complete denial (Greer 1992). A meta-analysis suggested that the prevalence of denial of the cancer diagnosis ranged from 4 to 47%, and denial of negative affect from 18 to 42% (Vos and De Haes 2007).

Although the term 'denial' is an accepted part of the medical vernacular, it is used in a variety of clinical circumstances, with varying definitions and little consensus. Furthermore, as with all of the body's defences - physiological, immunological, psychological - denial can become maladaptive.

This chapter will establish a pragmatic view of denial, explore how it functions within the clinician-patient relationship, and then demonstrate when intervention is appropriate and how that intervention is best undertaken. Specific attention will be given to the communication skills required for an effective clinical response to denial.
Original languageEnglish
Title of host publicationOxford Textbook of Communcation in Oncology and Palliative Care
EditorsDavid W. Kissane, Barry D. Bultz, Phyllis N. Butow, Carma L. Bylund, Simon Noble, Susie Wilkinson
Place of PublicationOxford UK
PublisherOxford University Press
Pages97-102
Number of pages6
Edition2nd
ISBN (Print)978-0-19-873613-4
Publication statusPublished - 2017

Keywords

  • denial; oncology; communication skills training, palliative care

Cite this

Sheahan, L., & Kissane, D. W. (2017). Denial and communication. In D. W. Kissane, B. D. Bultz, P. N. Butow, C. L. Bylund, S. Noble, & S. Wilkinson (Eds.), Oxford Textbook of Communcation in Oncology and Palliative Care (2nd ed., pp. 97-102). Oxford UK: Oxford University Press.
Sheahan, Linda ; Kissane, David W. / Denial and communication. Oxford Textbook of Communcation in Oncology and Palliative Care. editor / David W. Kissane ; Barry D. Bultz ; Phyllis N. Butow ; Carma L. Bylund ; Simon Noble ; Susie Wilkinson. 2nd. ed. Oxford UK : Oxford University Press, 2017. pp. 97-102
@inbook{90e1871c48034d4baa294b85567ce866,
title = "Denial and communication",
abstract = "Patients who appear not to acknowledge the diagnosis of an illness, or its gravity, are said to be 'in denial'. A patient's history readily illustrates this in Box 16.1.Denial is considered a common reaction, especially when an illness is life-threatening. After being told of the diagnosis of terminal cancer, approximately 20{\%} of patients deny they have cancer, 26{\%} partially suppress awareness of impending death, and 8{\%} demonstrate complete denial (Greer 1992). A meta-analysis suggested that the prevalence of denial of the cancer diagnosis ranged from 4 to 47{\%}, and denial of negative affect from 18 to 42{\%} (Vos and De Haes 2007).Although the term 'denial' is an accepted part of the medical vernacular, it is used in a variety of clinical circumstances, with varying definitions and little consensus. Furthermore, as with all of the body's defences - physiological, immunological, psychological - denial can become maladaptive.This chapter will establish a pragmatic view of denial, explore how it functions within the clinician-patient relationship, and then demonstrate when intervention is appropriate and how that intervention is best undertaken. Specific attention will be given to the communication skills required for an effective clinical response to denial.",
keywords = "denial; oncology; communication skills training, palliative care",
author = "Linda Sheahan and Kissane, {David W.}",
year = "2017",
language = "English",
isbn = "978-0-19-873613-4",
pages = "97--102",
editor = "Kissane, {David W.} and Bultz, {Barry D.} and Butow, {Phyllis N.} and Bylund, {Carma L.} and Simon Noble and Susie Wilkinson",
booktitle = "Oxford Textbook of Communcation in Oncology and Palliative Care",
publisher = "Oxford University Press",
address = "United Kingdom",
edition = "2nd",

}

Sheahan, L & Kissane, DW 2017, Denial and communication. in DW Kissane, BD Bultz, PN Butow, CL Bylund, S Noble & S Wilkinson (eds), Oxford Textbook of Communcation in Oncology and Palliative Care. 2nd edn, Oxford University Press, Oxford UK, pp. 97-102.

Denial and communication. / Sheahan, Linda; Kissane, David W.

Oxford Textbook of Communcation in Oncology and Palliative Care. ed. / David W. Kissane; Barry D. Bultz; Phyllis N. Butow; Carma L. Bylund; Simon Noble; Susie Wilkinson. 2nd. ed. Oxford UK : Oxford University Press, 2017. p. 97-102.

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Otherpeer-review

TY - CHAP

T1 - Denial and communication

AU - Sheahan, Linda

AU - Kissane, David W.

PY - 2017

Y1 - 2017

N2 - Patients who appear not to acknowledge the diagnosis of an illness, or its gravity, are said to be 'in denial'. A patient's history readily illustrates this in Box 16.1.Denial is considered a common reaction, especially when an illness is life-threatening. After being told of the diagnosis of terminal cancer, approximately 20% of patients deny they have cancer, 26% partially suppress awareness of impending death, and 8% demonstrate complete denial (Greer 1992). A meta-analysis suggested that the prevalence of denial of the cancer diagnosis ranged from 4 to 47%, and denial of negative affect from 18 to 42% (Vos and De Haes 2007).Although the term 'denial' is an accepted part of the medical vernacular, it is used in a variety of clinical circumstances, with varying definitions and little consensus. Furthermore, as with all of the body's defences - physiological, immunological, psychological - denial can become maladaptive.This chapter will establish a pragmatic view of denial, explore how it functions within the clinician-patient relationship, and then demonstrate when intervention is appropriate and how that intervention is best undertaken. Specific attention will be given to the communication skills required for an effective clinical response to denial.

AB - Patients who appear not to acknowledge the diagnosis of an illness, or its gravity, are said to be 'in denial'. A patient's history readily illustrates this in Box 16.1.Denial is considered a common reaction, especially when an illness is life-threatening. After being told of the diagnosis of terminal cancer, approximately 20% of patients deny they have cancer, 26% partially suppress awareness of impending death, and 8% demonstrate complete denial (Greer 1992). A meta-analysis suggested that the prevalence of denial of the cancer diagnosis ranged from 4 to 47%, and denial of negative affect from 18 to 42% (Vos and De Haes 2007).Although the term 'denial' is an accepted part of the medical vernacular, it is used in a variety of clinical circumstances, with varying definitions and little consensus. Furthermore, as with all of the body's defences - physiological, immunological, psychological - denial can become maladaptive.This chapter will establish a pragmatic view of denial, explore how it functions within the clinician-patient relationship, and then demonstrate when intervention is appropriate and how that intervention is best undertaken. Specific attention will be given to the communication skills required for an effective clinical response to denial.

KW - denial; oncology; communication skills training, palliative care

M3 - Chapter (Book)

SN - 978-0-19-873613-4

SP - 97

EP - 102

BT - Oxford Textbook of Communcation in Oncology and Palliative Care

A2 - Kissane, David W.

A2 - Bultz, Barry D.

A2 - Butow, Phyllis N.

A2 - Bylund, Carma L.

A2 - Noble, Simon

A2 - Wilkinson, Susie

PB - Oxford University Press

CY - Oxford UK

ER -

Sheahan L, Kissane DW. Denial and communication. In Kissane DW, Bultz BD, Butow PN, Bylund CL, Noble S, Wilkinson S, editors, Oxford Textbook of Communcation in Oncology and Palliative Care. 2nd ed. Oxford UK: Oxford University Press. 2017. p. 97-102