scholarly journals TP8.1.11 Discussing results and breaking bad news in breast video consultations: a pilot questionnaire

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Nader Touqan ◽  
Nabila Nasir ◽  
Kate Williams ◽  
Maria Bramley ◽  
M Shamim Absar
Keyword(s):  
Chest Wall ◽  
Cancer Diagnosis ◽  
Breast Surgery ◽  
Bad News ◽  
Clinical Settings ◽  
Breaking Bad News ◽  
Face To Face ◽  
Breaking Bad ◽  
Management Plans

Abstract Aim Virtual consultations (VC) in Breast Surgery have become well-established during the COVID pandemic. They are successfully utilised in routine follow ups and low-risk new referrals. We aimed to assess the utility of VC in more complex clinical discussions. Methods We collected feedback anonymously via electronic link from 20 consecutive patients who specifically had more challenging video-VC including: 12 diagnostic MDT results (10 patients received bad news of new cancer diagnosis, 2 had benign results); 6 post-operative wound checks with therapeutic MDT outcomes; 2 new consultations for chest wall reconstruction. Results The time saved by patients was between 1 and 3 hours (median=2). All patients felt that booking and joining a VC was either very easy (12) or easy (8). 18 patients were satisfied with the quality of sound and picture and all 18 felt they were able to communicate everything to the clinician during their VCs. Compared to a face-to-face consultation, 14 patients felt that VC was better (70%), 4 felt it was similar (20%) and 2 thought it was worse (10%). Most received comments were themed around VC had allowed patients to get their results, discuss their management plans and ask questions while they were safely at home with other family members, at times when COVID restrictions applied to outpatient clinical settings. Conclusion VC may be utilised selectively to provide complex consultations including discussing results, breaking bad news and wound inspections. Qualitative studies in this field can be beneficial.

scholarly journals Breaking cancer diagnosis news remotely during the Covid pandemic

2021 ◽  
pp. 205141582110001
Author(s):  
Babbin S John ◽  
Joshila Bhudoye ◽  
Mark F Lynch
Keyword(s):  
Cancer Diagnosis ◽  
Bad News ◽  
Breaking Bad News ◽  
Level Of Evidence ◽  
Face To Face ◽  
Breaking Bad ◽  
The Future ◽  
Cancer Specialists ◽  
Cancer Clinic

Breaking bad news is challenging in most circumstances, and informing a patient that they have a cancer diagnosis more so. Therefore, most patients have a face-to-face meeting with their doctor to get their cancer diagnosis with many advantages to this method. The SARS-Covid pandemic has forced cancer specialists to change their approach to giving cancer news and telemedicine is being utilised more than ever before. We describe the satisfaction outcomes of a series of patients who were given their cancer diagnosis by telephone during the pandemic. Our evaluation shows that cancer diagnosis can be safely given over the telephone and moreover the results can be used to design a bespoke cancer clinic of the future. Level of evidence: 4

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

2014 ◽  
Vol 03 (02) ◽  
pp. 116-121 ◽  
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.

Breaking Bad News About Cancer: Patients’ Preferences for Communication

2001 ◽  
Vol 19 (7) ◽  
pp. 2049-2056 ◽  
Author(s):  
Patricia A. Parker ◽  
Walter F. Baile ◽  
Carl de Moor ◽  
Renato Lenzi ◽  
Andrzej P. Kudelka ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Emotional Support ◽  
Bad News ◽  
Breaking Bad News ◽  
Message Content ◽  
Breaking Bad ◽  
Physician Characteristics ◽  
Context Variables ◽  
Content Scale

PURPOSE: The goal of this study was to assess patients’ preferences regarding the way in which physicians deliver news about their cancer diagnosis and management. PATIENTS AND METHODS: A sample of 351 patients with a variety of cancers completed a measure assessing their preferences for how they would like to be told news about their cancer. Patients rated characteristics of the context and content of the conversation as well as physician characteristics. RESULTS: Factor analysis indicated that patients’ preferences for how they would like to be told news regarding their cancer can be grouped into the following three categories: (1) content (what and how much information is told); (2) facilitation (setting and context variables); and (3) support (emotional support during the interaction). Women (P = .02) and patients with higher education (P = .05) had significantly higher scores on the Content scale, women (P = .02) had higher scores on the Support scale, and younger patients (P = .001) and those with more education (P = .02) had higher scores on the Message Facilitation scale. Medical variables were not associated with patients’ ratings of the importance of the three subscales. CONCLUSION: Patients rated items addressing the message content as most important, though the supportive and facilitative dimensions were also rated highly. Understanding what is important to patients when told news about their cancer provides valuable information that may help refine how this challenging task is best performed.

scholarly journals Breaking bad news to cancer patients in times of COVID-19

2021 ◽  
Author(s):  
Helen Hauk ◽  
Jürg Bernhard ◽  
Meghan McConnell ◽  
Benny Wohlfarth
Keyword(s):  
Communication Technologies ◽  
Critical Issue ◽  
Bad News ◽  
World Health ◽  
Breaking Bad News ◽  
Social Distancing ◽  
Face To Face ◽  
Breaking Bad ◽  
Adjustment To Illness ◽  
Health Organization

AbstractBreaking bad news is a mandatory provision in the professional life of nearly every physician. One of its most frequent occasions is the diagnosis of malignancy. Responding to the recipients’ emotions is a critical issue in the delivery of unsettling information, and has an impact on the patient’s trust in the treating physician, adjustment to illness and ultimately treatment. Since the World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020, several measures of social distancing and isolation have been introduced to our clinical setting. In the wake of these restrictions, it is important to reexamine existing communication guidelines to determine their applicability to face-to-face counseling in the context of social distancing, as well as to new communication technologies, such as telemedicine. We address these issues and discuss strategies to convey bad news the most empathetic and comprehensible way possible.

scholarly journals Breaking Bad News: A Valid Concern among Clinicians

2019 ◽  
Author(s):  
Gelareh Biazar ◽  
Kourosh Delpasand ◽  
Farnoush Farzi ◽  
Abbas Sedighinejad ◽  
Ali Mirmansouri ◽  
...  
Keyword(s):  
Communication Skill ◽  
Bad News ◽  
Breaking Bad News ◽  
Medical Sciences ◽  
Face To Face ◽  
Breaking Bad ◽  
Delivering Bad News ◽  
Environmental Supports ◽  
The Way

Objective: Delivering bad news is the duty of specialist physicians. However, they find it very difficult due to insufficient experience. In this study, the way faculty and residents of Guilan University of Medical Sciences (GUMS) delivered bad news to the patients was investigated. Method: This study was conducted at hospitals affiliated to GUMS during 2017. A questionnaire containing 18 items on environmental and psychical support was filled through a face to face interview. The first 10 questions evaluated psychical support and the next eight environmental supports. The scoring of each question ranged from 10 to 50, with 10 indicating “never” and 50 “always”. Results: According to the analysis of 235 questionnaires, only 32 (13.6%) of the participants had been taught to deliver bad news and 195(83%) felt they need educational courses. Also, 40 (17%) believed that they had enough ability to deliver these massages. No significant differences were observed among physicians who had taken teaching courses in breaking bad news to patients. Conclusion: This study revealed that educational courses to improve physicians’ communication skill to break bad news to patients are strongly warranted.

scholarly journals Training for difficult conversations and breaking bad news over the phone in the emergency department

2020 ◽  
pp. emermed-2020-210141
Author(s):  
Anna Collini ◽  
Helen Parker ◽  
Amy Oliver
Keyword(s):  
Emergency Department ◽  
Educational Interventions ◽  
Bad News ◽  
Emotional Impact ◽  
Breaking Bad News ◽  
Specific Training ◽  
Face To Face ◽  
Breaking Bad ◽  
Difficult Conversations ◽  
Stressful Task

Due to the COVID-19 pandemic, there have been strict limits on visitors to hospitals. This has led to clinicians having an increasing number of difficult conversations with patients and their relatives over the phone. There is a lack of published literature examining how to do this well, but it is recognised that phone communication does differ from face to face interactions, and requires specific training. What is most important to patients and their families when receiving bad news is privacy, adequate time without interruptions, clarity and honesty when delivering the information, and an empathetic and caring attitude. Much of the work done on breaking bad news has been done in oncology and focusses on face to face interaction; there has been an assumption that this is transferrable to the emergency department, and more recently that this is applicable to conversations over the phone. Multiple educational interventions to improve the delivery of bad news have been developed, with differing frameworks to help clinicians carry out this stressful task. Simulation is widely used to train clinicians to break bad news, and has solid theoretical foundations for its use. The psychological safety of participants must be considered, especially with emotive subjects such as breaking bad news. We believe there is a need for specific training in breaking bad news over the phone, and developed an innovative simulation-based session to address this. The training has been well received, and has also highlighted the need for a space where clinicians feel able to discuss the emotional impact of the difficult conversations they are having.

Effective Communication

2018 ◽  
Author(s):  
David Metcalfe ◽  
Harveer Dev
Keyword(s):  
Cancer Diagnosis ◽  
Effective Communication ◽  
Bad News ◽  
Breaking Bad News ◽  
Clinical Notes ◽  
Breaking Bad ◽  
Foundation Programme ◽  
Significant Life

Communication is fundamental to the role of the doctor. It includes routine verbal communication (e.g. history taking, updating relatives, handovers, and requesting investigations from specialists), written communication (e.g. prescriptions, updating the clinical notes, and discharge summaries), breaking bad news, and ‘challenging’ interactions such as dealing with an angry relative. Questions within this section assess your ability to communicate effectively with patients and colleagues. Effective communication requires understanding and being understood. You will need to demonstrate an ability to negotiate with colleagues, to document information within the medical notes clearly and concisely, to gather information from patients, and to listen to angry relatives. As always, your responses must adapt to the needs and context of each situation, while always remembering to demonstrate empathy and compassion. ● Listen to patients, relatives, and colleagues. They are trying to tell you something. ● Explain your position carefully after listening to the other side. ● Adapt your style as far as possible to the person with whom you are communicating. ● However strongly you feel, poor manners will never get the job done faster. Foundation doctors should not usually be left to ‘break bad news’ in the classical sense of a new cancer diagnosis in clinic. However, bad news can take many forms and it is likely that you will find yourself going through the ‘breaking bad news’ sequence many times during the foundation programme. For example, the following scenarios are all bad news to varying degrees. Some patients will take such developments in their stride and others will rank them amongst other significant life events. ● An incidental ‘nodule’ found on a CT chest that might be benign but will require a follow- up scan in three months. ● An elderly man who has become very unwell and is unlikely to survive while you are on call. You have been assigned the task of calling his wife, providing an update, and suggesting she come to the hospital urgently. ● The fact that investigations have all been normal and they are being discharged without a diagnosis for their persistent debilitating abdominal pain.

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

2017 ◽  
Vol 3 (3) ◽  
pp. 250-256 ◽  
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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