Preference of Adolescent and Young Adult Patients with Hematological Malignancy Regarding the Disclosure of Bad News

PURPOSE: To clarify communication preferences regarding the disclosure of bad news in adolescent and young adult (AYA) patients with hematological malignancies. METHODS: A cross-sectional study was conducted from January 2021 to March 2022 using a five-point Likert-scale questionnaire. Participants were patients diagnosed between the ages of 15-29 years and aged <40 years at the time of the survey. Preferences regarding physician communication during the disclosure of bad news were assessed. Trend tests were performed for items showing substantial interindividual variability. RESULTS: Data from 90 participants (49 male) were analyzed. Compared with adult cancer populations, AYA patients were less likely to prefer receiving bad news in the presence of family or to prioritize reassurance or emotional support. Over 90% preferred detailed and concrete information about their medical condition, including unfavorable information, and wanted physicians to listen to their distress and concerns. Seventy percent preferred receiving information about life expectancy. Participants wanted physicians to break bad news to them first while also valuing physicians' consideration for their family members. Trend test results indicated that a preference for "Using indirect or softened wording" when delivering bad news was associated with younger age at diagnosis (<20 years), male sex, and shorter time since diagnosis (<5 years). Married participants more often preferred "Breaking bad news before it is fully confirmed." CONCLUSION: AYA patients generally prefer clear and accurate disclosure of medical information while valuing physicians' consideration for their family members. Many prefer factual information before or alongside emotional support, highlighting the need for flexible, individualized communication strategies.