Medical professionals’ perspectives and experiences in disclosing a dementia diagnosis: a grounded theory study

Guided by patient autonomy and future care plans, most families of patients with dementia prefer to be fully informed of their condition. However, medical professionals follow different considerations regarding whether the diagnosis should be disclosed. This study primarily examined physicians’ experiences through in-depth explorations of their actual diagnostic disclosure practices, integrating their perspectives to provide appropriate forms of disclosure. A grounded theory approach was employed, and 16 neurologists, geriatricians, and psychiatrists who disclosed diagnoses in clinical practice were recruited. A semistructured interview guide was used. Each interview was audio-recorded, transcribed, and analysed using the constant comparative. The core category of this study was overcoming problems through honest disclosure. The four major categories describe the participants’ experiences in disclosing a diagnosis. These include Duty to disclose, where clinical physicians have an obligation to truthfully reveal diagnostic results; Adjusting narratives, which involves adjusting communication based on acceptance levels within a limited time; Maintaining daily routines, focused on delaying disease progression and helping maintain daily life functioning; and Providing support and company, which instructs on interaction patterns between persons with dementia and caregivers. Clinical physicians advocate for truthfully disclosing disease diagnoses, resolving the existing life difficulties of dementia patients and their relatives, and helping them live with their disease. Through open discussion and clarification, understanding and support are conveyed regarding care needs, and caregivers’ burdens and capabilities are accurately assessed, which has important effects on subsequent care and mutual communication.