Table 3 Participating Japanese primary care physicians’ comfort with disclosing dementia to patients, explanations for their choices and comparison of across the four groups (2017)

High

(8~10)

n = 9

“They come to see me because they want to know. So I would avoid telling them anything vague.” (Urban, female)

“In the case of a patient whose cognitive level is low, I will talk to the family members rather than the patient.” (Rural, male)

“I try not to do it by myself as much as possible…I usually ask a social worker, nurse or care manager to join.” (Rural, male)

-No hesitation for disclosure

-Collective approach to patients and family members

-Seek cooperation of other professionals

Moderate (5~7)

n = 9

“I think dementia patients have fear about the future. I am not sure if I am taking care of such feelings well enough.” (Urban, male)

“I don’t know at all if my way of disclosing dementia is appropriate. I have never received feedback from anyone.” (Urban, female)

-Concerns about patients’ feelings

-Not sure about appropriate ways of disclosing dementia

Low

(2~4)

n = 4

“Because it is an incurable disease, I don’t have confidence to tell the diagnosis to patients.” (Urban, male)

“The measure of whether or not to disclose to patients is rather unclear in my thinking”. (Rural, male)

“I have been accused by my patient, ‘Don’t you dare treat me like a demented man!’” (Urban, female)

-Negative perceptions of dementia

-Hesitation for disclosure

-Feeling somewhat “guilty” for their own attitudes

No responders

n = 2

“[On remote islands] People take it as one event life’s course. They would say, forgetfulness is just a natural aging process, it’s OK.” (Rural, female)

“I don’t’ see any merit to telling the dementia diagnosis to patients.” (Urban, male)

-No need or benefit to disclosing dementia