Perspectives of Colombian medicine students about their formation on breaking bad news: A cross-sectional study

Background: Communication between physicians and patients is a fundamental aspect of cancer care. Bad news could be defined as "any information, which adversely affects an individual's view of his or her future”. The aim of the research study was to explore the patient’s perspective on receiving cancer news and their expectations regarding the same.Methods: A cross-sectional study was performed in our tertiary care teaching hospital. 50 consenting cancer patients from 18 to 60 years of age were interviewed on the basis of a structured, validated questionnaire.Results: On analysis of the 50 patients ‘answers, it was found that 37 were females and 13 were males, the average age being 50.07 years. The common diagnosis in females was breast cancer (20 patients) and in males it was lung cancer (5 patients). All the patients wanted relatives present with them when the bad news was broken to them. In 66.6% patients, the news was broken by a junior resident, 15% of the doctors didn't greet the patients, 10% of the patients were told the news suddenly, while 99% of the doctors didn’t explain any positive aspects of the disease related to the treatment outcome.Conclusions: This study provides an insight into the expectations of patients from their physicians with regard to the process of breaking bad news.

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Training and Validation of Incognito Standardized Patients for Assessing Oncology Fellows’ Performance Regarding Breaking Bad News

International Journal of Cancer Management ◽

10.5812/ijcm.113183 ◽

2021 ◽

Vol 14 (5) ◽

Author(s):

Mandana Shirazi ◽

Amir Hossein Emami ◽

Afsaneh Yakhforoshha

Keyword(s):

Rating Scale ◽

Reliability And Validity ◽

Role Playing ◽

Cross Sectional Study ◽

Bad News ◽

Breaking Bad News ◽

Rater Agreement ◽

Real Patient ◽

Cross Sectional ◽

Breaking Bad

Background: Standardized patient (SP) has been applied to measure learner’s communication challenges such as breaking bad news (BBN). When utilizing SP-based assessment, 2 steps should be considered in SP training; assessing SPs portrayal as the real patient (authenticity) and how SPs checklist fill out reproducibility. Objectives: In this study, we described the process of training authentic and consistent SPs for evaluating oncology fellows’ performance regarding BBN in Iran. Methods: In this cross-sectional study, 8 eligible SPs took part in a 3-day educational meeting. Four different scenarios were developed regarding cancer patients along with corresponding checklists representing common presentations of illness. The accuracy of SPs portrayal was evaluated by experts, using a previously validated rating scale during observation of their role-playing. The reproducibility of SPs’ portraits was measured, using a test-retest approach. The inter-rater agreement of the SPs’ ability to fill out the BBN scale was measured by comparing the correlation between the SPs, who completed the scale, and oncologist faculty members’ judgments, which is considered a gold standard. Results: The findings of this study indicated that the cut-off score for the SPs’ portrayal validity was 95%. The reliability of SPs portrayal was acceptable (r = 0.89). The inter-rater agreement between SPs and experts in filling the BBN scale (k = 0.82), as well as, the consistency of filling the BBN scale between SP groups were highly acceptable (k = 0.86). Conclusions: The present study has demonstrated that if SP is trained appropriately, they shave a high degree of reliability and validity to assess oncology fellows’ performance regarding BBN skills.

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BREAKING BAD NEWS IN A NEONATAL INTENSIVE CARE: THE PARENT’S EVALUATION

Revista Paulista de Pediatria ◽

10.1590/1984-0462/2020/38/2019092 ◽

2020 ◽

Vol 38 ◽

Author(s):

Ligia Marçola ◽

Ivete Zoboli ◽

Rita Tiziana Verardo Polastrini ◽

Silvia Maria Macedo de Barbosa

Keyword(s):

Intensive Care ◽

Congenital Malformations ◽

Neonatal Intensive Care ◽

Cross Sectional Study ◽

Bad News ◽

Breaking Bad News ◽

Cross Sectional ◽

Breaking Bad ◽

Training Professionals ◽

The Way

ABSTRACT Objective: To describe the reports of parents of newborns (NB) with congenital malformations hospitalized in a Neonatal Intensive Care Unit (NICU) who received bad news, in order to identify the issues related to the perception of bad news given adequately or inadequately. Methods: A cross-sectional study was conducted from January to October 2018, in which parents of newborns with congenital malformations hospitalized in NICUs were interviewed at visiting hours, according to inclusion criteria. The questionnaire had semi-structured questions related to reception of bad news. Analysis of the data was descriptive. Results: 28 mothers and two fathers were interviewed and 16 (53.3%) reported having had at least one bad news in the NICU. Of those, 10 (62.5%) considered appropriate the way in which the news was given. The justifications were: sincerity of the professional, delicacy to give the news, giving hope to the family, use of appropriate words and demonstration of caring about the newborn. Six participants (37.5%) considered inadequate the way of breaking bad news. The reasons were: unpreparedness and lack of knowledge about the child’s case, use of difficult language, haste or anxiety and discouragement of family hope. Most of the news was given by a professional alone, often by a medical resident. Conclusions: The communication of bad news was considered adequate by the parents, although this perception was not unanimous. This study, therefore, indicates that it is necessary to improve the communication of bad news in this NICU. Training professionals can assist in this process.

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Patients’ Needs In Breaking Bad News For Cancers Diagnosis: Preliminary Result

Journal of Clinical Medicine- Hue Central Hospital ◽

10.38103/jcmhch.2020.64.4 ◽

2020 ◽

Author(s):

Cuong Dinh Ngoc

Keyword(s):

Cancer Patients ◽

Cross Sectional Study ◽

Bad News ◽

Breaking Bad News ◽

Cross Sectional ◽

Breaking Bad ◽

The People ◽

Central Vietnam ◽

Diagnosis Of Cancer ◽

Giving Bad News

Introduction: How to perform a breaking bad news consultation properly with the present circumstances and especially it fits the local people. The way to deliver bad news to cancer patients was studied and practiced widely in the world. Some studies were conducted in Vietnam but not yet in central Vietnam. The people here are quite different in thinking and personality. Hence, they may need and expect consultation differently. The study was performed to note the needs of patients in the breaking bad news of cancer and to explore their own experience of giving bad news. Methods: A cross-sectional study was conducted on 44 cancer patients undergoing treatment at the Hue University of Medicine and Pharmacy hospital in July 2020. Results: Of 44 patients, The age average was 56.73. Male was more prevalent in the study with 61.4%. About 45.5% of patients expected to be explained in a private room and most of them desired to hear the truth at the same time with their family (68.2%), only 4.5% of patients wanted the bad news to be delivered only to their families. One hundred percent of patients preferred their oncologists to explain the bad news. More than 80% of patients wanted you received all at once. Patients were interested in getting information about the diagnosis of cancer, stage of cancer, cost of the treatment, treatment option to be selected and results of clinical studies were less important to them. They mostly wanted the truth to be delivered to them than to the family for most of the information contents given by the researchers. Conclusions: Patients in the study wanted to know the truth but some information was more important than others according to them. They mostly satisfied with the breaking bad news that has been done.

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Delivering Bad News to Patients: Survey of Physicians, Patients, and Their Family Members’ Attitudes

Shiraz E-Medical Journal ◽

10.5812/semj.109016 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Amir Bazrafshan ◽

Asma Zendehbad ◽

Seyed Ali Enjoo

Keyword(s):

Negative Impact ◽

Family Members ◽

Cross Sectional Study ◽

Bad News ◽

Breaking Bad News ◽

Cross Sectional ◽

Breaking Bad ◽

Medical News ◽

Delivering Bad News

Background: Breaking bad news to patients is an unpleasant process, but it is essential for the medical team, which is giving information about a person’s illness; without proper planning, it leads to a negative impact on people’s feelings and quality of life. Cultural differences can be effective in telling bad news. Objectives: This study aimed to identify the attitudes of physicians, patients, and patients’ families towards breaking bad medical news. Methods: This cross-sectional study was performed among physicians, patients, and their families referred to Namazi Hospital, Shiraz, Iran, during 2016 - 2017. Their attitudes regarding how to tell bad news were evaluated by self-administrated questionnaires. Results: A total of 397 valid questionnaires completed by physicians, patients, and their families were analyzed in this study. All groups of participants preferred telling bad news to patients about the diagnosis of their disease; they also believed that in the case of a patient’s dissatisfaction, this information should not be given to other family members. Patients’ family members would rather tell lies to the patient about their diagnosis. Conclusions: There is a tendency towards not telling bad news in Iranian culture; Iranian people tend to protect those around them, and the desire to give bad news to those around them is lower than the tendency to hear bad news about one’s own illness. With increasing education, the tendency to telling bad news increases.

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Breaking bad news of cancer diagnosis – Perception of the cancer patients in a rural community in Malaysia

South Asian Journal of Cancer ◽

10.4103/2278-330x.130447 ◽

2014 ◽

Vol 03 (02) ◽

pp. 116-121 ◽

Cited By ~ 4

Author(s):

Mathew Gabriel Bain ◽

Cheah Whye Lian ◽

Chang Ching Thon

Keyword(s):

Cancer Patients ◽

Cancer Diagnosis ◽

Current Method ◽

Bad News ◽

Breaking Bad News ◽

Language Management ◽

Cross Sectional ◽

Breaking Bad ◽

Information Giving ◽

Significant Difference

Abstract Context: Breaking of bad news is an important component in the management of cancer patients. Aims: This study aimed to assess the perceptions of breaking bad news of cancer diagnosis. Settings and Design: It was a cross-sectional study using Breaking Bad News Assessment Schedule (BAS) questionnaire on cancer patients in Serian district. Materials and Methods: Using snowballing sampling method, a total of 134 patients were interviewed face-to-face after the consent was obtained from each of the respondents. Statistical Analysis Used: Data was entered and analyzed using SPSS version 19.0. Results: Majority were comfortable with the current method of breaking bad news. The main aspects found to be the areas of concern were the importance of the usage of body language, management of time and identifying patients′ key area of concerns. There were significant difference between sex and "information giving" (P = 0.028) and "general consideration" (P = 0.016) and also between "the age and setting the scene" (P = 0.042). Significant difference was also found between the types of cancer and "the setting of scene" (P = 0.018), "breaking bad news technique" (P = 0.010), "eliciting concerns" (P = 0.003) and "information giving" (P = 0.004). Conclusion: Good and effective communication skill of breaking bad news is vital in the management of cancer patients. As the incidence of new cases of cancer increase every year, breaking of bad news has become a pertinent to the medical professionals′ role. Specific aspects of communication skills based on local characteristics should be more emphasized in the formulation of training for doctors.

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Barriers and facilitating communication skills for breaking bad news: from the specialists’ practice perspective

Colombia Medica ◽

10.25100/cm.v40i2.638 ◽

1969 ◽

Vol 40 (2) ◽

pp. 158-166

Author(s):

Enna Catalina Payán ◽

David Andrés Montoya ◽

John Jairo Vargas ◽

María Clara Vélez ◽

Alfonso Castaño ◽

...

Keyword(s):

Action Plan ◽

Point Of View ◽

Communication Process ◽

Bad News ◽

Breaking Bad News ◽

Cross Sectional ◽

Breaking Bad ◽

Survey Results ◽

Level Of Knowledge ◽

Delivering Bad News

Introduction: Breaking bad news is one of a physician’s most difficult duties. There are several studies related to the patient’s needs, but few reflect on the doctors’ experience. Materials and method: A descriptive, cross-sectional research was carried out to study issues related to the process of delivering bad news which might act as barriers and facilitating skills from the doctor’s point of view. These issues were identified through a self-administered survey. Results: Participant doctors use different strategies to communicate bad news to their patients. Examples of these strategies are: to be familiar with the patients’ medical history, to ensure that there is enough time, to know the patient’s caregivers and/or relatives, to determine the patient’s level of knowledge about his/her condition, to use non-technical words, to give information in small pieces, to assess the patient’s understanding, to devise a joint action plan, among others. Conclusion: The communication barriers that were identified focused on the emotional issues of the communication process, particularly those related to the recognition of own emotions, and the limited training about communication strategies available to doctors. Consequently, there is a need to implement training programs that provide doctors with tools to facilitate the bad news communication process.

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Breaking bad news from the doctors’ perspective in a paternalistic society: the case of Sudan

Tropical Doctor ◽

10.1177/0049475518795765 ◽

2018 ◽

Vol 48 (4) ◽

pp. 340-344 ◽

Cited By ~ 1

Author(s):

Mohamed S Muneer ◽

Ahmed E Elhassan ◽

Ahmed M Osman ◽

Abdelmohaymin A Abdalla ◽

Mohamed A Abdelrahim ◽

...

Keyword(s):

Bad News ◽

Breaking Bad News ◽

Health Providers ◽

Cross Sectional ◽

Global Challenge ◽

Breaking Bad ◽

Attitude And Practice ◽

The Right To Know ◽

The Right ◽

Previous Training

Breaking bad news is a global challenge for all types of health providers. Our study assessed the attitude and practice from the doctors’ perspective in a patriarchal society. A descriptive cross-sectional hospital-based study was conducted, involving doctors from both medical and surgical departments. Almost half of the respondents believed that Sudanese patients do not like to know their diagnosis, and a slightly higher proportion had no previous training on how to break bad news. Some 20% indicated that they would conceal the diagnosis from a patient if his or her relatives so requested. Less than one-quarter of respondents followed a standard protocol. Although most of the doctors subscribed to the notion that patients have the right to know everything about their illnesses, not all of them held this attitude towards their local patient population.

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