COMMUNICATION ISSUES BETWEEN CAREGIVERS AND PATIENTS WITH CONCEALMENT OF ADVANCED-STAGE CANCER: A QUALITATIVE STUDY Introduction: Communication is a key element of palliative care. e concealment of advanced-stage diseases is a communication challenge. is study aimed to explore the patterns and diculties in communication regarding the concealment of advanced-stage cancer between caregivers and patients. Methods: is qualitative study employed an interpretive phenomenological approach and was conducted at a district hospital in ailand. Semi-structured in-depth interviews were performed to collect data from caregivers (i.e. family members) of patients regarding the concealment of advancedstage cancer. e data analysis followed an inductive thematic approach. Results: Ten in-depth interviews were conducted among the caregivers of patients aged 57–97 years. Four themes emerged: (i) reasons for concealing the diagnosis and prognosis (personality of patients and concerns about negative eects), (ii) communication patterns between caregivers and patients (communicating symptoms/signs instead of the diagnosis/prognosis and distorting information), (iii) diculties and challenges in maintaining concealment (feelings of guilt, hesitation in sharing the information and suspicion of patients’ awareness of their diagnosis/prognosis) and (iv) communication support from healthcare professionals (avoiding informing patients about their diagnosis/prognosis, supporting decision-making and disclosing the information). Conclusion: e concealment of advanced-stage cancer is perceived as an appropriate communication approach among some caregivers. Communicating information about advanced-stage cancer is dynamic. Some caregivers and families consider disclosing the information in the future. Healthcare professionals can support communication throughout care. Future studies should focus on decision-making and communication processes for better handling of information concealment or the conspiracy of silence in palliative care.

Physical inactivity is a global health burden. Promoting physical activity in primary care through physical activity counseling is an effective intervention. This article provides an overview of and perspectives on physical activity counseling in primary care. The identification of physical inactivity as a health problem may increase the awareness of physical inactivity among patients and primary care providers, which will lead to an action plan. The contents of physical activity counseling should be based on evidence-based recommendations. Safety issues should be evaluated appropriately to optimize the utilization of primary care services. Physical activity counseling methods should be “tailored” for an individual using appropriate counseling methods and setting-specific resources. Multilevel barriers to physical activity counseling in primary care (i.e., healthcare providers, patients, and systems) must be addressed. Setting-specific strategies to overcome these barriers should be implemented to maximize the effectiveness of physical activity counseling in primary care.

Physical inactivity is a global health burden. Promoting physical activity in primary care through physical activity counseling is an effective intervention. This article provides an overview of and perspectives on physical activity counseling in primary care. The identification of physical inactivity as a health problem may increase the awareness of physical inactivity among patients and primary care providers, which will lead to an action plan. The contents of physical activity counseling should be based on evidence-based recommendations. Safety issues should be evaluated appropriately to optimize the utilization of primary care services. Physical activity counseling methods should be “tailored” for an individual using appropriate counseling methods and setting-specific resources. Multilevel barriers to physical activity counseling in primary care (i.e., healthcare providers, patients, and systems) must be addressed. Setting-specific strategies to overcome these barriers should be implemented to maximize the effectiveness of physical activity counseling in primary care.