Scholars have made great efforts to investigate the antecedents of knowledge sharing. In the current study, we applied the proactive motivation model (Parker, Bindl, and Strauss, 2010) to propose a theoretical model to advance this research line and examined the relationship between coaching and knowledge sharing. A total of 197 supervisor–subordinate dyads from a logistics company completed the survey questionnaire. Our results show that leaders’ coaching behavior positively relates to employees’ knowledge sharing behavior via psychological availability. Furthermore, our results show (...) that team psychological safety climate moderates the relationship between psychological availability and employees’ knowledge sharing behavior, as well as the indirect effect between leaders’ coaching behavior and employees’ knowledge sharing. (shrink)

ABSTRACTDeception has been reported to be influenced by task-relevant emotional information from an external stimulus. However, it remains unclear how task-irrelevant emotional information would influence deception. In the present study, facial expressions of different valence and emotion intensity were presented to participants, where they were asked to make either truthful or deceptive gender judgments according to the preceding cues. We observed the influence of facial expression intensity upon individuals’ cognitive cost of deceiving. Larger cost was observed for high intensity faces (...) compared to low intensity faces. These results provided insights on how automatic attraction of attention evoked by task-irrelevant emotional information in facial expressions influenced individuals’ cognitive cost of deceiving. (shrink)

This study, which is based on survey data provided by 445 employees of a Chinese enterprise, examines the impact of authentic leadership on the proactive behavior of subordinates, in particular the mediating effect of subordinate psychological capital and the moderating effect of the compassion at work. The results of our structural equation model reveal that: (1) There is a significant positive correlation between authentic leadership and the proactive behavior of subordinates; (2) Psychological capital plays a full mediating role between authentic (...) leadership and subordinate proactive behavior; (3) Compassion at work has a moderating effect on the positive relationship between authentic leadership and subordinate psychological capital and proactive behavior. (shrink)

本书内容包括:社区与精神文明、城市社区精神文明建设的历史考察、社区服务与城市社区精神文明建设、社区文化与城市社区精神文明建设、社区环境与城市社区精神文明建设、社区精神与城市社区精神文明建设等.

Ben shu shi zuo zhe cong du shu bi ji zhong xie qu de yi zu san wen sui bi, fan ying le zuo zhe zai yi shu he zhe xue shang de tan suo yu zhui qiu.

This paper includes seven chapters. The first chapter discusses the purport and the structure of Vimalakirti Nirdesa Sutra. Its purport is inconceivable liberation-development and liberation of living beings-purification of Buddha-fields. These three items are one essentially, the inconceivable liberation being the essence of its purport and the development and liberation of living beings and the purification of Buddha-fields being the function of it. Essence and function are identical. This sutra has a structure that goes forward step by step and arranges (...) in a crisscross pattern. The second chapter discusses the thought of sunya. On one hand, this sutra follows and develops the thought of sunya in the Prajn~a^pa^ramita^-su^tra while paying much emphasis on the middle-way sunya, on the other hand, it is characterized by two points in the way of its thought of sunya: all things standing on the root which is baseless and surpassing it within e qu-sunya. The third chapter argues the thought of middle way and non-discrimination. The domain of the bodhisattva embodies the thought of middle way. The thought of middle way of this sutra influenced greatly Na^ga^rjuna who claimed eight-not middle way. Jizang and Zhiyi followed and developed the thought of his. Nonduality is without discrimination. The dharma of nonduality is middle way dharmata^. The theory of dharmata^ is profound and abstruse, being without any form and beyond speech. Entering-the Dharma-door of nonduality has three layers of meaning. Nonduality is inconceivable and entering-the Dharma-door of nonduality is inconceivable liberation. The idea of nonduality of this sutra had a profound impact on Huineng’s Tanjing and Jizang’s thought of nonduality in four-layer two truths. The theory of sunya, middle way and non-discrimination discussed in the above two chapters, is the way of thinking of this sutra which is named as the negative affirming. Without the way of thinking of this kind, no sentient beings were gifted with the great compassion and skill in liberative technique.Without it, there were no developing and liberating living beings and purifying Buddha-fields. The fourth chapter discusses the thought of inconceivable liberation. In general, the Inconceivable is that which is beyond contemplation or conceptualization, beyond linguistic expression. In this sutra, apart from the above significance, the Inconceivable is equal to Liberation. The essence of inconceivable liberation is developing and liberating living beings and purifying Buddha-fields, is being released in liberation without abandoning the passions that are the province of the world, is following the way to attain the qualities of the Buddha, is neither destroying the compounded nor resting in the uncompounded, is being beyond the world without abandoning it. The fifth chapter argues the probability and method of developing and liberating sentient beings, that is, the thought of the Buddha-qualities and skill in liberative technique. The family of the Tathagatas', being constituted by all passions, is different from the true mind, the pure mind, the tatha^gatagarbha or the Buddha-nature. So it is certain that the thought of the Buddha-qualities would develop into the idea which insists on all sentient beings having the Buddha-nature. Zhiyi’s theory of evil-nature was evolved from the thought of the family of the Tathagatas'. The skill in liberative technique has many meanings: (1) A method, a means, a device for saving sentient beings; "expedient means" (upa^ya). "Excellent method for converting beings" (upa^ya-kau/salya). The wisdom of being able to save sentient beings by knowing discriminated phenomena. A temporary teaching established in order to lead sentient beings to the true teaching. This is a subject of primary importance in the Lotus Sutra. (2) A plan, scheme, design (a^rambha). (3) Usage of metaphor in teaching. (4) Chinese Buddhists utilized the doctrine of expedient means to help deal with the hermeneutical problem of reconciling the disparities among the different teachings attributed to the Buddha-to explain that the differences in the teachings of the Buddha delivered in his forty-nine year ministry were the result of the different audiences he addressed. The sixth chapter discusses how to purify the Buddha-fields. When we say that the purity of the Buddha-field reflecting the purity of one’s own mind, the mind is not the transcendental pure one, but the empirical one after arousing the thought of intention to achieve enlightenment. The purity of one’s own mind leading to the purity of the Buddha-field, means that the pure Buddha-field are constructed not only by purifying his own mind but also by purifying all living beings’ minds. Huineng’s idea of “one’s own mind is Buddha immediately” and the argument of “one’s own mind is pure Buddha-field immediately” are greatly different from the thought of the purity of one’s own mind leading to the purity of the Buddha-field. The seventh chapter discusses the relation between this sutra and householder-Buddhism and the secularization of Buddhism. This sutra doesn’t gives theoretical arguments for the householder-Buddhism and the secularization of Buddhism. (shrink)

Military metaphors are pervasive in biomedicine, including HIV research. Rooted in the mind set that regards pathogens as enemies to be defeated, terms such as “shock and kill” have become widely accepted idioms within HIV cure research. Such language and symbolism must be critically examined as they may be especially problematic when used to express scientific ideas within emerging health-related fields. In this article, philosophical analysis and an interdisciplinary literature review utilizing key texts from sociology, anthropology, history, and Chinese and (...) African studies were conducted to investigate the current proliferation of military metaphors. We found the use of these metaphors to be ironic, unfortunate, and unnecessary. To overcome military metaphors we propose to give them less aggressive meanings, and/or replace them with more peaceful metaphors. Building on previous authors' work, we argue for the increased use of “journey” metaphors as meaningful, cross-culturally app... (shrink)

In his recent works on daily face-to-face encounters, Zahavi claims that the phenomenon of sharing involves reciprocity. Following Zahavi’s line of thought, we wonder what exactly reciprocity amounts to and how the shared experience emerges from the dynamic process of interaction. By turning to the highly specialized field of elite sports dance, we aim at exploring the way in which reciprocity unfolds in intensive deliberate practices of movement. In our analysis, we specifically argue that the ongoing dynamics of two separate (...) flows of movement constitute a shared experience of dancing together. In this sense, moving together, in sports dance, is a practical way of understanding each other. In agreement with Zahavi, our analysis emphasizes the bi-directed nature of sharing. However, at the same time, we contribute to Zahavi’s ongoing endeavour as the special case of sports dance reveals how reciprocity can be deliberately shaped through the mutual coordination and affective bound dynamics of movement. Our article thus both pursues the methodological point that qualitative research of expert competences can constructively enrich phenomenological analysis and indicates how movement can be fundamental to the reciprocity of shared experience. (shrink)

How do we become moral persons? What about children's active learning in contrast to parenting? What can children teach us about knowledge-making more broadly? Answer these questions by delving into the groundbreaking ethnographic fieldwork conducted by anthropologists Arthur and Margery Wolf in a martial law era Taiwanese village (1958-60), marking the first-ever study of ethnic Han children. Jing Xu skillfully reinterprets the Wolfs' extensive fieldnotes, employing a unique blend of humanistic interpretation, natural language processing, and machine-learning techniques. Through a (...) lens of social cognition, this book unravels the complexities of children's moral growth, exposing instances of disobedience, negotiation, and peer dynamics. Writing through and about fieldnotes, the author connects the two themes, learning morality and making ethnography, in light of social cognition, and invites all of us to take children seriously. This book is ideal for graduate and undergraduate students of anthropology and educational studies. (shrink)

Shame is frequently viewed as a destructive emotion; but it can also be understood in terms of change and growth. This essay highlights the problematic values that cause pervasive and frequent shame and the importance of resisting and changing these values. Using Confucian insights, I situate shame in an interactive process between the individual's values and that of their society, thus, being vulnerable to shame represents both one's connection to a community and an openness to others’ negative feedback. This process (...) provides an important arena where personal values interact with communal ones. The Confucian tradition, I argue, affords individuals a degree of autonomy in internalization through urging them to cultivate and maintain a keen sense of shame. My discussion also offers resources for understanding the various aspects of this interactive process—how individuals with similar experiences of shame may, through channeling their experiences, influence social values and propel moral progress. (shrink)

This book presents a variety of discussions from different countries about regulations and applications of ethics in business practice. It demonstrates how Ethics, both in the world of business and in academic life, is consistently a central and unavoidable issue that institutions must devise new regulations on a regular basis to address. Given that applying such regulations becomes complicated in a global business landscape and that International companies have lost large amounts of revenues due to fraudulent activities, the book provides (...) insights for professionals in business world to teach, learn, apply, measure and report on companies' daily business. Business and Professional Ethics: Theories, Standards, and Analysis is essential reading for researchers and students in business schools around the world. (shrink)

One stable marker of face perception appears to be left-side bias, the tendency to rely more on information conveyed by the left side of the face than the right. Previous studies have shown that left-side bias is influenced by familiarity and prior experience with face stimuli. Since other-race facial recognition is characterized by reduced familiarity, in contrast to own-race facial recognition, the phenomenon of left-side bias is expected to be weaker for other-race faces. Among Chinese participants, face inversion has been (...) found to eliminate the left-side bias associated with own-race faces. Therefore, it is of interest to know whether face inversion influences left-side bias for non-Chinese research participants and can be generalized across own- and other-race faces. This study assessed 65 Caucasian participants using upright and inverted chimeric Caucasian and Asian faces in an identity similarity-judgment task. Although a significant left-side bias was observed for upright own-race faces, this bias was eliminated by facial inversion, indicating that such a bias depends on the applicability of configural processing strategies. For other-race faces, there was no left-side bias in the upright condition. Interestingly, the inverted presentation yielded a right-side bias. These results show that while left-side bias is affected by familiarity differences between own- and other-race faces, it is a universal phenomenon for upright faces. Inverted presentation strongly reduces left-side bias and may even cause it to revert to right-side bias, suggesting that left-side bias depends on configural face processing. (shrink)

Previous studies have explored children’s intergroup resource allocation in the context of preexisting intergroup resource inequality. However, resource inequality between social groups often originates from different factors. This study explored the role of the origins of resource inequality on children’s intergroup resource allocations. In experiment 1, when there was no explicit origin of the intergroup inequality, children of different ages mainly allocated resources in an equal way and 5- to 6-year-olds showed ingroup bias. In experiment 2, we examined the influence (...) of different origins of intergroup inequality and found that 5- to 6-year-olds perpetuated intergroup inequality when resource inequality was based on either a structural or an internal factor. However, 10- to 11-year-olds rectified inequality or allocated equally when intergroup inequality was based on regional disparity and perpetuated resource inequality when intergroup inequality was based on performance difference. The origins of inequality appear to play an important role in children’s intergroup resource allocations, and older children can distinguish different origins of intergroup inequality in resource allocation. (shrink)

Emoji appear to be an important cue to judge whether a statement is sarcastic in computer-mediated communication. In this study, we investigated whether the smiling emoji, an indicator of sarcastic intention in the Chinese culture, exerts an influence on sarcasm interpretation across the lifespan. Statements accompanied with or without a smiling emoji were compared in unambiguous (Experiment 1) and ambiguous (Experiment 2) contexts. The results of Experiment 1 illustrated that for teenagers and the 20-year-olds the smiling emoji enhanced the perceived (...) sarcasm of sarcastic statements significantly. However, there was no difference in interpreting sarcastic statements with or without a smiling emoji in other age groups. Experiment 2 replicated the results of Experiment 1. We found both teenagers and the 20-year-olds were more likely to arrive at a sarcastic interpretation of the ambiguous statement followed by a smiling emoji, which were less frequent in participants aged in their 30s, 40s, 50s and individuals over 60 years old. This might be because people of varying ages differ in decoding the emotions of the emoji. Age-related differences in the use of sarcasm and participants’ experiences with using emoji might be possible factors that were closely related to the interpretation of emoji-based sarcasm. (shrink)

Drawing from a wide range of primary historical and sociological sources, this book presents medical ethics in China from a Chinese-Western comparative perspective, and in doing so it provides a fascinating exploration of cultural differences and commonalities exhibited by China and the West in medicine and medical ethics. The book focuses on a number of key issues in medical ethics including: attitudes towards foetuses; disclosure of information by medical professionals; informed consent; professional medical ethics; and human rights. This careful examination (...) not only provides insights into Chinese viewpoints, but also sheds light on the appropriate methods for comparative culture and ethical research. Through its analysis, Jing-Bao Nie seeks to put forward a theory of "transcultural bioethics", an ethical paradigm which upholds the primacy of morality whilst resisting cultural stereotypes, and appreciating the internal plurality, richness, dynamism and openness of medical ethics in any culture. Medical Ethics in China will be of particular interest to students and academics in the fields of Medical Law, Bioethics and Medical Ethics as well as Chinese/Asian Studies and Comparative (Chinese-Western) Cultural Studies. (shrink)

In recent years, with the development of society and the rapid development of the animation industry, people are paying more and more attention to and requirements for animation production. As an indispensable part of animation production, picture composition plays a major role in animation production. It can give full play to the application of color matching and light and shadow design and enhance the depth and space of the animation screen. Tone space conversion refers to the conversion or representation of (...) color data in one color space into corresponding data in another color space. Its purpose is to distinguish and process color components such as hue and saturation in an image. This article first introduces the domestic and foreign research status of digital image preprocessing and analyzes the basic principles of several color space conversions in detail. Then, several color space conversion algorithms are studied, and the performance of the algorithms is compared and analyzed. The paper focuses on the hardware implementation and optimization of the algorithm for converting RGB color space into HSI color space to meet the real-time requirements. This article focuses on the mutual conversion between the RGB tone space and the HSI tone space and describes in detail how each color component in the HSI tone space is converted from the three RGB color components from a geometric perspective, and then the conversion is derived, and several general conversion methods of RGB to HSI tone space are introduced; two conversion methods of geometric derivation method and standard modulus algorithm are implemented in the software, and the comparison verification is carried out, and the comparison is made from the perspective of hardware implementation. The pros and cons of the two methods are discussed. Finally, the paper summarizes the shortcomings in the design and proposes further research directions in the future. (shrink)

本书对处于社会转型期中国的审美文化特性以及其中出现的种种让人困惑的问题,从不同角度、不同层面作了阐述。.

To monopolize the scientific data gained by Japanese physicians and researchers from vivisections and other barbarous experiments performed on living humans in biological warfare programs such as Unit 731, immediately after the war the United States government secretly granted those involved immunity from war crimes prosecution, withdrew vital information from the International Military Tribunal for the Far East, and publicly denounced otherwise irrefutable evidence from other sources such as the Russian Khabarovsk trial. Acting in “the national interest” and for the (...) security of the US, authorities in the US tramped justice and morality, and engaged in what the English common law tradition clearly defines as “complicity after the fact.” To repair this historical injustice, the US government should issue an official apology and offer appropriate compensation for having covered up Japanese medical war crimes for six decades. To help prevent similar acts of aiding principal offender in the future, international declarations or codes of human rights and medical ethics should include a clause banning any kind of complicity in any unethical medicine—whether before or after the fact—by any state or group for whatever reasons. (shrink)

Trust is indispensable not only for interpersonal relationships and social life, but for good quality healthcare. As manifested in the increasing violence and tension in patient-physician relationships, China has been experiencing a widespread and profound crisis of patient–physician trust. And globally, the crisis of trust is an issue that every society, either developing or developed, has to face in one way or another. Yet, in spite of some pioneering works, the subject of patient-physician trust and mistrust – a crucial matter (...) in healthcare especially because there are numerous ethical implications – has largely been marginalized in bioethics as a global discourse. Drawing lessons as well as inspirations from China, this paper demonstrates the necessity of a trust-oriented bioethics and presents some key theoretical, methodological and philosophical elements of such a bioethics. A trust-oriented bioethics moves beyond the current dominant bioethical paradigms through putting the subject of trust and mistrust in the central agenda of the field, learning from the social sciences, and reviving indigenous moral resources. In order for global bioethics to claim its relevance to the things that truly matter in social life and healthcare, trust should be as vital as such central norms like autonomy and justice and can serve as a potent theoretical framework. (shrink)

Does motor behavior early in development have the same signatures of habituation, dishabituation, and Spencer-Thompson dishabituation known from infant perception and cognition? And do these signatures explain the choice preferences in A not B motor decision tasks? We provide new empirical evidence that gives an affirmative answer to the first question together with a unified neural dynamic model that gives an affirmative answer to the second question.In the perceptual and cognitive domains, habituation is the weakening of an orientation response to (...) a stimulus over perceptual experience. Switching to a novel stimulus leads to dishabituation, the re-establishment of the orientation response. In Spencer-Thompson dishabituation, the renewed orientation response transfers to the original stimulus. The change in orientation responses over perceptual experience explains infants' behavior in preferential looking tasks: Familiarity preference early during exposure and novelty preference late during exposure. In the motor domain, perseveration in the A not B task could be interpreted as a form of familiarity preference. There are hints that this preference reverses after enough experience with the familiar movement. We provide a unified account for habituation and patterns of preferential selection in which neural dynamic fields generate perceptual or motor representations. The build-up of activation in excitatory fields leads to familiarity preference, the build-up of activation in inhibitory fields leads to novelty preference. We show that the model accounts for the new experimental evidence for motor habituation, but is also compatible with earlier accounts for perceptual habituation and motor perseveration. We discuss how excitatory and inhibitory memory traces may regulate exploration and exploitation for both orientation to objects and motor behaviors. (shrink)

Extensive conflicts of interest at both individual and institutional levels are identifiable in scientific research and healthcare in China, as in many other parts of the world. A prominent new case from China is He Jiankui’s experiment that produced the world’s first gene-edited babies and that raises numerous ethical, political, socio-cultural, and transnational questions. Serious financial and other COI were involved in He’s genetic adventure. Using He’s infamous experiment as a case study, this paper explores the wider issue of financial (...) and other COI in scientific research and healthcare in China, especially institutional conflict of interest and policy-related COI. Taking a socio-ethical perspective, it examines China’s state policies and its massive efforts to transform and commercialize scientific research, the lack of policies and oversight mechanisms for regulating COI, as well as major ethical issues arising from COI including the undermining of public trust. Some practical suggestions are offered for institutional reform and institutional development so that COI, particularly ICOI, can be avoided or more effectively managed in scientific research in China. (shrink)

Contemporary bioethical issues are inherently cross-cultural and global in their scope. This is not surprising, as bioethical matters touch everyone in one way or another. Moral quandaries in health-care, life sciences, and biotechnology do not respect natural and human boundaries, the boundaries between and within nation-states, ethnicities, cultures, communities, and social groups. In addition, the simultaneously large-scale and intimate interactions between and within different cultures and civilizations and the rapid pace at which they change are phenomena that distinguish our times (...) from previous eras. Bioethics—as a particular domain of public discourse and an academic discipline—has thus been rapidly... (shrink)

To investigate the phenomenon of patient–physician mistrust in China, a qualitative study involving 107 physicians, nurses and health officials in Guangdong Province, southern China, was conducted through semi-structured interviews and focus groups. In this paper we report the key findings of the empirical study and argue for the essential role of medical professionalism in rebuilding patient-physician trust. Health professionals are trapped in a vicious circle of mistrust. Mistrust leads to increased levels of fear and self-protection by doctors which exacerbate difficulties (...) in communication; in turn, this increases physician workloads, adding to a strong sense of injustice and victimization. These factors produce poorer healthcare outcomes and increasingly discontented and angry patients, escalate conflicts and disputes, and result in negative media coverage, all these ultimately contributing to even greater levels of mistrust. The vicious circle indicates not only the crisis of patient-physician relationship but the crisis of medicine as a profession and institution. Underlying the circle is the inherent conflict of interest in the healthcare system by which health professionals and hospitals have become profit-driven. This institutional conflict of interest seriously compromises the fundamental principle of medical professionalism—the primacy of patient welfare—as well as the traditional Chinese ideal of “medicine as the art of humanity”. Patient trust can be restored through rectifying this institutional conflict of interest and promoting medical professionalism via a series of recommended practical measures. (shrink)

How should we understand the emotional rationality? This first part will explore two models of cognition and analogy strategies, test their intuition about the emotional desire. I distinguish between subjective and objective desire, then presents with a feeling from the "paradigm of drama" export semantics, here our emotional repertoire is acquired all the learned, and our emotions in the form of an object is fixed. It is pretty well in line with the general principles of rationality, especially the lowest reasonable (...) principles. Turned to the second part of this side of reasonable. I will inquire how emotional beliefs, desires, and behaviors contribute to the rationality. I will present a very general biological hypothesis: emotions by controlling highlights the characteristics of perception and reasoning, so that we remove the difficulties due in particular to lead to paralysis; they are being simulated by a simplified perception of information, thus limiting our practice and cognitive choice. How are we to understand emotional or axiological rationality? I pursue analogies with both the cognitive and the strategic models, testing them against intuitions about emotional desires. We distinguish two different classes of desires, the subjective and the objective, and propose that emotions have a semantics that derives from "paradigmatic scenarios", in terms of which our emotional repertoire is learned and the formal objects of our emotions fixed. This fits in well with emerging facts about how our emotional capacities develop, and it can also be squared with the general principles of rationality, particularly minimal rationality. In the second part, I return to the perspective of rationality. I ask how emotions contribute to the rationality of beliefs, desires, and behavior. I proffer a very general biological hypothesis: Emotions spare us the paralysis potentially induced by a particular predicament by controlling the salience of features of perception and reasoning; they temporarily mimic the informational encapsulation of perception and so circumscribe our practical and cognitive options. (shrink)

: Since the late 1970s, American appraisals of Chinese medical ethics and Chinese responses to American bioethics range from frank criticism to warm appreciation, from refutation to acceptance. Yet in the United States as well as in China, American bioethics and Chinese medical ethics have been seen, respectively, as individualistic and communitarian. In this widely-accepted general comparison, the great variation in the two medical moralities, especially the diversity of Chinese experiences, has been unfortunately minimized, if not totally ignored. Neither American (...) bioethics nor Chinese medical ethics is a field with only one dominant way of thinking. Medical moralities in America and China--traditional and modern--have always been plural and diverse. For example, American and Chinese cultures and medical moralities both exhibit individualistic and communitarian traditions. For this reason, bioethics in general and cross-cultural bioethics in particular must be fundamentally interpretive. Interpretive cross-cultural bioethics appreciates the plurality of medical morality within any culture. It can serve as a vital means of social and cultural criticism through engaged interpretations. (shrink)

There exists a serious shortage of organs for transplantation in China, more so than in most Western countries. Confucianism has been commonly used as the cultural and ethical reason to explain the reluctance of Chinese and other East-Asian people to donate organs for medical purposes. It is asserted that the Confucian emphasis on xiao (filial piety) requires individuals to ensure body intactness at death. However, based on the original texts of classical Confucianism and other primary materials, we refute this popular (...) view. We base our position on the related Confucian norms of filial piety and ren (humaneness, humanity or benevolence), the tension between differentiated love and universal love, and belief in the goodness of human nature. In light of this, we argue that the Confucian ethical outlook actually calls for organ donation at an individual level, and supports an opt-out (presumed consent) system at the level of social policy. Furthermore, because the popular view is based on a number of dominant but misleading modes of thinking about cultural differences, our revisionist account of Confucian moral duties regarding organ donation has implications for developing a more adequate transcultural and global bioethics. These will be discussed and expanded upon. (shrink)

Background:Doctors should disclose the diagnosis to patients according to the principle of autonomy. However, not disclosing the diagnosis and prognosis to cancer patients remains common in mainland China.Objective:The study explored the experiences and attitudes of patients with cancer, family members, and the medical staff in truth-telling.Research design:A quantitative survey with three closed-ended questionnaires was conducted.Participants:In all, 137 patients with cancer, 134 family members caring for cancer cases, and 54 medical staff were surveyed. Descriptive statistics were used to summarize all characteristics, (...) and the chi-square test was performed to analyze group differences in attitudes toward cancer disclosure.Ethical considerations:This study was approved by the Committee on Ethics of Biomedicine Research, at the Second Military Medical University (HJEC-2018-YF-001). Informed consent was obtained from all participants prior to study commencement.Findings:A total of 59.8% of patients were informed about their diagnosis within 1 week, and 19.7% inferred theirs. The medical staff preferred to prioritize family members in informing about patient diagnosis while 77.4% of patients preferred to be told the whole truth at the time of initial diagnosis. More patients than family members and medical staff wanted the patients to be informed about the diagnosis ( p < 0.001). A significant difference was found between the patients and family members regarding who should tell the patients.Discussion:The willingness of patients in knowing the truth was underestimated by their family members as well as the medical staff. Guessing the truth indirectly may exert negative effects on the patients, and not telling the truth is inappropriate in patients who want to be informed.Conclusion:Disclosure of a cancer diagnosis is a complex process involving medical practice, as well as a range of cultural, ethical, and legal factors. The medical staff should first assess each patient’s willingness in truth-telling and inform about disease diagnosis with respect. Emotional support and comfort from family members are encouraged. Anyone in the patient’s care team, especially nurses, could be integrated in the process of truth-telling. (shrink)