Supplemental Material for Enhancing Residents’ Compassionate Communication to Family Members: A Family Systems Breaking Bad News Simulation

Comunicare “cattive notizie” ai pazienti rappresenta un compito non facile: indubbiamente le modalità ed il contesto in cui tali notizie vengono comunicate hanno importanti implicazioni sia per il medico sia per il destinatario delle informazioni, ovvero assicurare un contesto adeguato (ambiente confortevole e riservato, disponibilità di tempo) per permettere al paziente ed ai familiari di porre domande o esprimere emozioni e paure; la possibilità che un amico o un familiare del paziente sia presente, per assicurare al paziente supporto e la sensazione di non essere solo nella gestione di tale situazione; una buona comunicazione medico-paziente-familiari. In particolare, la comunicazione delle cattive notizie dovrebbe avvenire in maniera tale che il paziente e i familiari comprendano la situazione, anche per poter partecipare al processo decisionale, ma in modo tale da non aggravare il malessere derivante dalla natura delle stesse notizie. ---------- Breaking bad news to patients can be a difficult task: certainly how the news are conveyed and the circumstances surrounding the receipt of the news have implications for the giver and the receiver, i.e. to assure an appropriate setting (comfortable and quiet location, sufficient time) to allow for the patient and the family members to ask questions or express emotions and fears; the possibility for a patient’s friend or relative to be present – to provide the patient with a sense of support and a belief that he/ she does not have to deal with the crisis alone -; a good communication between physician and patient/ family. In particular, breaking bad news process must ensure that the patient or family comprehend the news – to understand the situation and participate in decision-making process – but in ways that not exacerbate the discomfort associated with the news itself.

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Breaking Bad News: Notifying family members of a death in the emergency department

10.51684/firs.591 ◽

2015 ◽

Author(s):

Justin Morgenstern

Keyword(s):

Emergency Department ◽

Family Members ◽

Bad News ◽

Breaking Bad News ◽

Breaking Bad

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Would the Saudi Family Agree to Tell the Truth to Cancer Patient? Exploring Awareness, Perception, and Attitude to Truth Telling.

10.21203/rs.3.rs-666697/v1 ◽

2021 ◽

Author(s):

MOHAMMAD ABOSOUDAH ◽

Balaji Duraisamy

Keyword(s):

Family Caregivers ◽

Family Members ◽

Bad News ◽

Confirmatory Test ◽

Breaking Bad News ◽

Do Not Resuscitate ◽

Full Disclosure ◽

Code Status ◽

Breaking Bad ◽

Diagnosis And Prognosis

Abstract Aim:To study the differences in attitude and perceptions of patients versus family members with regards to breaking bad news and full disclosure of prognosis to the patients in a tertiary care center in Saudi Arabia. Methods:A survey of patients and their family members was conducted in the oncology outpatient clinics using a structured questionnaire. Based on the existing prevalence of patients who wanted full disclosure, the sample size was calculated to be 143. Demographic details, diagnostic details were collected in addition to responses to questions exploring attitudes towards breaking bad news. A total of 149 patients and family members were interviewed separately. Results:A total of 149 patients and their family members consented to be interviewed. However, only valid responses to each question were analyzed. Overall, 75.2% (109/145) of patients felt that patient should be informed first as compared to 72.9% (102/140) of family members who felt the family should be informed of the bad news first. 24.3% (34) of family caregivers agreed that patients have the right to full disclosure. Both patients and family caregivers were reluctant to know details about the code status. 71.4% (95) of family caregivers and 54.3% (75) of the patients did not want the health care team to discuss details of code status and DNR. Both patients (87.1%) and caregivers (74.3%) agreed that the primary physician is the best person to break the bad news. Family members may be emotionally more affected than patients. They might require as much if not more support as the patients themselves during breaking bad news.Conclusions:There are significant differences between patient and family members regarding full disclosure of diagnosis and prognosis especially, end-of-life issues like DNR and place of death. The most stressful time for the patient was waiting for confirmatory test results. Therefore, breaking bad news support services should systematically begin even before diagnostic investigations begin. Our study points out that the majority of patients want to know the full details of diagnosis and prognosis. Discussion regarding code status has to be more structured in a way that the patient and family do not feel abandoned due to the Do Not Resuscitate status. Further study is needed to study the need and efficacy of a breaking bad news system in the hospital.

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Breaking Bad News in Ethnic Settings: Perspectives of Patients and Families in Northern Sri Lanka

Journal of Global Oncology ◽

10.1200/jgo.2016.005355 ◽

2017 ◽

Vol 3 (3) ◽

pp. 250-256 ◽

Cited By ~ 1

Author(s):

Chrishanthi Rajasooriyar ◽

Jenny Kelly ◽

Thanikai Sivakumar ◽

Gowcikan Navanesan ◽

Shahini Nadarasa ◽

...

Keyword(s):

Sri Lanka ◽

Cancer Diagnosis ◽

Information Seeking ◽

Family Members ◽

Developed Countries ◽

Bad News ◽

Breaking Bad News ◽

Breaking Bad ◽

Diagnosis And Prognosis ◽

Disclosure Of Diagnosis

Purpose The discussion of a cancer diagnosis and prognosis often is difficult. This study explored the expectations of Tamil-speaking patients with cancer and their families with respect to receiving their cancer diagnosis in northern Sri Lanka. Methods This exploratory, descriptive, qualitative study used semistructured interviews. Results Thematic analysis identified two major themes: communication and information seeking. The findings illustrate a discrepancy between patient preference for direct disclosure of the diagnosis and that of families. Ninety-five percent of patients wanted medical staff to disclose their cancer diagnosis, whereas only 45% of family members believed that the diagnosis should be disclosed to the patient rather than to the family. Conclusion Although patients and their family members’ views and expectations of the disclosure of diagnosis and prognosis differ, a majority of patients want to be told directly about their diagnosis rather than to learn of it from a relative. The findings are similar to the literature on other ethnic groups from Sri Lanka and studies from English-speaking developed countries. Therefore, the main questions are how to educate families and physicians about the benefits of open disclosure to patients and how to change culture. Results of this study along with a previous study call for the development of strategies and guidelines to improve societal views, educate patients and families, and train health professionals in the area of breaking bad news and discussing prognosis in the Sri Lankan setting.

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Breaking Bad News: Patient Preferences and the Role of Family Members when Delivering a Cancer Diagnosis

Asian Pacific Journal of Cancer Prevention ◽

10.7314/apjcp.2016.17.4.1779 ◽

2016 ◽

Vol 17 (4) ◽

pp. 1779-1784 ◽

Cited By ~ 6

Author(s):

Abha Rao ◽

Bhuvana Sunil ◽

Maria Ekstrand ◽

Elsa Heylen ◽

Girish Raju ◽

...

Keyword(s):

Cancer Diagnosis ◽

Patient Preferences ◽

Family Members ◽

Bad News ◽

Breaking Bad News ◽

Breaking Bad

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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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