Document Type : Original Article


1 Nursing and Midwifery Sciences Development Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran

2 Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran

3 Nursing and Midwifery Care Research Center, Facualty of Nursing and Midwifery, Isfahan University of Medical Science, Isfahan, Iran

4 Department of Radiotherapy and Oncology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

5 Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

6 Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran


Background: The present study was conducted to investigate the effect of implementing domestic truth-telling protocol on stress, anxiety, and depression in cancer patients.
Method: In this study, a semi-experimental design was used to examine the effect of truth-telling protocol implementation on psychological factors (i.e., stress, anxiety, and depression) in cancer patients. A total of 60 cancer patients participated in this study, 30 of them in the intervention group (who informed their disease with truth-telling protocol) and 30 others in the control group (who informed their disease with usual way and without protocol). Patients’ psychological factors were compared in intervention and control groups, three and eight weeks after the cancer disclosure by depression, anxiety, and stress scale-21.
Results: In this study, except higher stress level of patients in intervention compared to the control group, no statistically significant difference was seen in other variables three weeks after cancer disclosure (P=0.046, Z= -1.99). Eight weeks after the intervention, all variables were significantly lower in the intervention group (P=0.000, Z=-5.864; P= 0.000, Z=-0.651; P=0.000, Z=-5.351).
Conclusion: Exercising truth-telling practice through implementing a localized culture-based protocol, especially after passing the initial acute phase of hearing the bad news, can lead to improved psychological factors in cancer patients.