scholarly journals Breaking bad news: tackling cultural dilemmas

2021 ◽  
pp. bmjspcare-2020-002700
Author(s):  
Sophie Nilusha Holmes ◽  
Jan Illing
Keyword(s):  
Emotional Support ◽  
Common Ground ◽  
Breaking Bad News ◽  
Communication Tool ◽  
Breaking Bad ◽  
The Family ◽  
Widespread Phenomenon ◽  
Building Rapport ◽  
The Relationship ◽  
Professional Dilemma

AbstractRequesting that serious diagnoses be concealed from patients, a widespread phenomenon in many cultures, presents a professional dilemma. Practical and sensitive communication strategies are needed.MethodologyIn this paper, we use analysis of the existing literature to develop a communication tool for practitioners facing requests for diagnostic non-disclosure. Our approach builds on existing strategies, in providing a mnemonic communication tool, permitting more than one outcome, and focusing on the need for mutual understanding and cooperation.ResultsExisting work on this dilemma highlights the need to appreciate the family's standpoint, affirm their benevolent intentions and correct misperceptions. To this end, we have developed a mnemonic tool, 'ARCHES', to be used in situations where the family has requested diagnostic non-disclosure. The model has six stages: acknowledge the request for non-disclosure, build the relationship, find common ground, honour the patient's preferences and outline the harm of non-disclosure, provide emotional support and devise a supportive solution.ConclusionFacing requests for diagnostic non-disclosure is a challenge of communication. The dilemma is particularly marked when practising across cultures. Our model gives a structure for building rapport with the family and realigning their misperceptions while upholding the patient's right to knowledge.

Breaking bad news: caring for the family

1995 ◽  
Vol 10 (11) ◽  
pp. 31-33 ◽  
Author(s):  
Sylvia Dear
Keyword(s):  
Bad News ◽  
Breaking Bad News ◽  
Breaking Bad ◽  
The Family

Clinicians’ moral distress and family satisfaction in the intensive care unit

2018 ◽  
Vol 25 (12) ◽  
pp. 1894-1904 ◽  
Author(s):  
Giulia Lamiani ◽  
Matteo Ciconali ◽  
Piergiorgio Argentero ◽  
Elena Vegni
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Emotional Support ◽  
Moral Distress ◽  
Family Satisfaction ◽  
Satisfaction With Care ◽  
Decision Making Process ◽  
The Family ◽  
Distress Scale ◽  
The Relationship

This study explored the relationship between clinicians’ moral distress and family satisfaction with care in five intensive care units in Italy. A total of 122 clinicians (45 physicians and 77 nurses) and 59 family members completed the Italian Moral Distress Scale-Revised and the Family Satisfaction in the ICU questionnaire, respectively. Clinicians’ moral distress inversely correlated with family satisfaction related to the inclusion in the decision-making process. Specifically, physicians’ moral distress inversely correlated with satisfaction regarding the respect shown toward the patient. Nurses’ moral distress inversely correlated with satisfaction regarding breathlessness and agitation management, provision of emotional support, understanding of information, and inclusion in the decision-making process.

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.

Het effect van personalisatie en leeftijdscongruentie in narratieve communicatie op website satisfactie en recall van online gezondheidsinformatie

2013 ◽  
Vol 41 (4) ◽  
Author(s):  
Nadine Bol ◽  
Julia van Weert ◽  
Hanneke de Haes ◽  
Eugène Loos ◽  
Ellen Smets
Keyword(s):  
Health Information ◽  
Emotional Support ◽  
Information Age ◽  
Online Health Information ◽  
Communication Tool ◽  
Mediation Effects ◽  
Narrative Engagement ◽  
The Relationship ◽  
Moderating Role ◽  
Practical Implications

The effect of personalization and age congruency in narrative communication on website satisfaction en recall of online health information. The effect of personalization and age congruency in narrative communication on website satisfaction en recall of online health information. The effect of personalization and age congruency on website satisfaction and recall of information was tested in a 2 (personalization: personalized vs. nonpersonalized video) × 2 (age congruency: congruent vs. incongruent) experimental design (n = 275). Personalization was found to be an effective communication tool to predict recall of information. Age congruency had an effect on satisfaction with the emotional support from the website. Narrative engagement predicted both website satisfaction and recall of information, but did not mediate the relationship between personalization and the outcomes. However, significant conditional mediation effects revealed that age congruency plays a moderating role in explaining the effects of personalization on website satisfaction and recall of online health information via narrative engagement. This study provides practical implications for developing online health messages for older adults.

Breaking Bad News in Oncology: A Metasynthesis

2015 ◽  
Vol 33 (22) ◽  
pp. 2437-2443 ◽  
Author(s):  
Guilhem Bousquet ◽  
Massimiliano Orri ◽  
Sabine Winterman ◽  
Charlotte Brugière ◽  
Laurence Verneuil ◽  
...  
Keyword(s):  
Bad News ◽  
Breaking Bad News ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Major Step ◽  
Breaking Bad ◽  
The Family ◽  
Points Of View ◽  
Critical Appraisal Skills ◽  
Physician Patient

Purpose The delivery of bad news by oncologists to their patients is a key moment in the physician-patient relationship. We performed a systematic review of qualitative studies (a metasynthesis) that focused on the experiences and points of view of oncologists about breaking bad news to patients. Methods We searched international publications to identify relevant qualitative research exploring oncologists' perspectives about this topic. Thematic analysis, which compensates for the potential lack of generalizability of the primary studies by their conjoint interpretation, was used to identify key themes and synthesize them. NVivo qualitative analysis software was used. Results We identified 40 articles (> 600 oncologists) from 12 countries and assessed their quality as good according to the Critical Appraisal Skills Programme (CASP). Two main themes emerged: the patient-oncologist encounter during the breaking of bad news, comprising essential aspects of the communication, including the process of dealing with emotions; and external factors shaping the patient-oncologist encounter, composed of factors that influence the announcement beyond the physician-patient relationship: the family, systemic and institutional factors, and cultural factors. Conclusion Breaking bad news is a balancing act that requires oncologists to adapt continually to different factors: their individual relationships with the patient, the patient's family, the institutional and systemic environment, and the cultural milieu. Extending the development of the ability to personalize and adapt therapeutic treatment to this realm of communications would be a major step forward from the stereotyped way that oncologists are currently trained in communication skills.

scholarly journals Newly discovered associations between peritrich ciliates (Ciliophora: Peritrichia) and scale polychaetes (Annelida: Polynoidae and Sigalionidae) with a review of polychaete–peritrich epibiosis

2019 ◽  
Author(s):  
Barbara Mikac ◽  
Federica Semprucci ◽  
Loretta Guidi ◽  
Massimo Ponti ◽  
Marco Abbiati ◽  
...  
Keyword(s):  
Original Description ◽  
First Record ◽  
Careful Attention ◽  
The North ◽  
Ciliate Species ◽  
The Family ◽  
Widespread Phenomenon ◽  
First Time ◽  
The Relationship ◽  
Scanning Electron

Abstract In this research, we report the presence of two ciliate protozoans of the subclass Peritrichia, Cothurnia amphicteis and C. peloscolicis, as epibionts on the chaetae of scaled polychaetes Malmgrenia lilianae, M. andreapolis (fam. Polynoidae) and Sthenelais boa (fam. Sigalionidae), from the north Adriatic (Mediterranean Sea). Both ciliate species are herein found for the first time after their original description and are redescribed, based on light and scanning electron microscopy analyses. This is the first record of an association between ciliates and polychaetes of the family Sigalionidae. Our results suggest that these host–epibiont relationships might be highly specific. We also present the first review of epibiosis between polychaetes and peritrich ciliates, indicating that this relationship is more diverse than previously thought. Forty taxa of peritrich ciliates from 12 genera and seven families are recorded as epibionts on polychaetes, while 48 polychaete taxa are known as their hosts. The relationship can be considered ectocommensalism, where the ciliates have the advantages of increased food availability. This association might be a more widespread phenomenon than currently known, because it could be easily overlooked or misinterpreted. It, therefore, deserves careful attention and further investigation.

scholarly journals DUKUNGAN KELUARGA DAN KEPATUHAN DIET PENDERITA DIABETES MELLITUS

2016 ◽  
Vol 2 (2) ◽  
pp. 90
Author(s):  
Susanti Susanti
Keyword(s):  
Diabetes Mellitus ◽  
Family Support ◽  
Emotional Support ◽  
Correlation Study ◽  
Statistical Test ◽  
Cross Sectional ◽  
The Family ◽  
Approach Method ◽  
Support Relationships ◽  
The Relationship

Kepatuhan penderita diabetes mellitus dalam penatalaksanaan penyakitnya sangat penting untuk menghindari masalah penurunan derajat kesehatan. Kendala utama pada penanganan diet diabetes mellitus adalah kejenuhan pasien dalam mengikuti terapi diet yang sangat diperlukan untuk mencapai keberhasilan. Solusi meningkatkan kepatuhan membutuhkan dukungan keluarga yang berupa dukungan emosional, dukungan penghargaan, dukungan informatif dari anggota keluarga kepada penderita. Penelitian ini mencoba membuktikan apakah ada hubungan antara dukungan keluarga dengan kepatuhan pada penderita diabetes mellitus. Penelitian ini menggunakan studi korelasi dengan pendekatan metode cross sectional. Sampel penelitian ini adalah penderita diabetes yang bersedia menjadi responden sebanyak 30 pasien. Variabel dependen adalah kepatuhan, variabel independen adalah dukungan keluarga. Instrumen yang digunakan adalah kuisioner. Analisa data yang digunakan adalah secara deskriptif, dan uji SPSS. Analisis data menggunakan software computer. Hasil uji statistik dukungan keluarga dengan kepatuhan pada penderita diabetes mellitus didapatkan hasil p = 0,138 dimana α > 0,05 sehingga dapat disimpulkan bahwa H0 diterima, yaitu secara statistik tidak ada hubungan yang bermakna antara dukungan keluarga dengan kepatuhan pada penderita diabetes mellitus. Kesimpulan dari penelitian ini adalah dukungan keluarga tidak begitu berpengaruh terhadap kepatuhan penderita dalam penatalaksanan DM. Namun, faktor lain yang berpengaruh terhadap kepatuhan adalah pendidikan dan modifikasi lingkungan untuk pengedalian penyakit diabetes mellitus yang dideritanya. Kata kunci: Dukungan keluarga, kepatuhan, Diabetes Mellitus ABSTRACT Implementation of diet of diabetes mellitus sufferer is strongly influenced by the support of the family. Family support in the form of emotional support, esteem support, informative support from family members. If the family support is not there then the sufferer would not comply with diabetes mellitus in the implementation of the diet. The purpose of this study was to identify the relationship between family support with obedienceon sufferer of diabetes mellitus. The design used a correlation study with cross sectional approach method. Samples were diabetic sufferers who were willing to become respondents. There were 30 respondents. Analysis of data used computer software.In statistical test family support relationships with obediencein sufferer of diabetes mellitus showed p = 0,138 where α >0.05 so that it can be concluded that H0 accepted, there was no statistically significant correlation between family support with obedience in with sufferers diabetes mellitus.Individuals who have received the support of family or not, it remains a good level of obedience. Due to their understanding of instructions, beliefs, attitudes, and personality. Keywords: Family Support, Obedience, Diabetes Mellitus DOWNLOAD FULL TEXT PDF >>

scholarly journals Informazione e comunicazione in caso di patologia con prognosi grave o infausta: considerazioni etiche e medico-legali

2011 ◽  
Vol 60 (2) ◽  
Author(s):  
Paola Delbon ◽  
Adelaide Conti ◽  
Massimo Gandolfini
Keyword(s):  
Decision Making ◽  
Family Members ◽  
Bad News ◽  
Decision Making Process ◽  
Breaking Bad News ◽  
Sufficient Time ◽  
Good Communication ◽  
Breaking Bad ◽  
The Family

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.

scholarly journals Hubungan Dukungan Keluarga dengan Kejadian Depresi pada Usia Tua di Nagari Tanjung Banai Aur, Kecamatan Sumpur Kudus, Kabupaten Sijunjung Tahun 2012

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Figa Prima Dani ◽  
Yaslinda Yaunin ◽  
Edison Edison
Keyword(s):  
Family Support ◽  
Old Age ◽  
Emotional Support ◽  
Sampling Method ◽  
Stratified Sampling ◽  
Cross Sectional ◽  
Appraisal Support ◽  
The Family ◽  
Relationship Of ◽  
The Relationship

AbstrakDepresi pada usia tua merupakan keadaan yang ditandai dengan perasaan sedih, kurang bersemangat, merasa gelisah, penurunan konsentrasi, selalu berpikiran buruk, dan susah untuk sosialisasi dengan lingkungan sekitar serta mudah putus asa dalam menghadapi masalah. Dengan adanya dukungan keluarga berupa dukungan informasi, dukungan penilaian, dukungan instrumental, dan dukungan emosional akan menurunkan kejadian depresi pada usia tua. Penelitian ini bertujuan untuk mengetahui hubungan dukungan keluarga dengan kejadian depresi pada usia tua di Nagari Tanjung Banai Aur, Kecamatan Sumpur Kudus, Kabupaten Sijunjung. Jenis penelitian yang digunakan adalah observasional dengan pendekatan cross sectional. Sampel yang diambil dalam penelitian ini adalah usia tua yang berumur lebih dari 60 tahun yang tinggal bersama keluarganya di Nagari Tanjung Banai Aur, Kecamatan Sumpur Kudus, Kabupaten Sijunjung yaitu sebanyak 82 orang, dengan metode pengambilan sampelnya adalah stratified sampling. Usia tua yang mengalami depresi memiliki dukungan keluarga rendah. Terdapat hubungan yang signifikan antara dukungan keluarga dengan kejadian depresi pada usia tua di Nagari Tanjung Banai Aur, Kecamatan Sumpur Kudus, Kabupaten Sijunjung.Kata kunci: usia tua, depresi pada usia tua, dukungan keluargaAbstractDepression in old age is a state characterized with feelings of sadness, less excited, feeling jittery, decreased concentration, always thinking bad, and hard to socialize with their surroundings and easy to despair in dealing with problems. With the support of the family such as informational support, appraisal support, instrumental support, and emotional support will reduce the incidence of depression in old age. This study is aimed to determine the relationship of family support with the incidence of depression in old age in Nagari Tanjung Aur Banai, Kecamatan Sumpur Kudus Kabupaten Sijunjung. The study’s method is an observational with cross-sectional approach. Samples in this study were people with age more than 60 years who lives with his/her in Nagari Tanjung Aur Banai, Kecamatan Sumpur Kudus Kabupaten Sijunjung, which were counted as 82 people, and taken by stratified sampling method. old age with depression have low family support. There is a significant relationship between family support with the incidence of depression in old age in Nagari Tanjung Aur Banai, Kabupaten Sijunjung.Keywords:aging, depression in old age, family support

scholarly journals THE INFLUENCE OF SOCIAL AND PSYCHOLOGICAL ATTITUDES OF MODERN SPOUSES ON THEIR MARRIAGE SATISFACTION

2020 ◽  
Vol 2020 (1) ◽  
pp. 5-13
Author(s):  
Irina Pospelova ◽  
Olena Kosianova
Keyword(s):  
Emotional Support ◽  
Motivational Orientation ◽  
Influential Factor ◽  
Motivational Orientations ◽  
Marriage Satisfaction ◽  
Level Of Satisfaction ◽  
The Social ◽  
The Family ◽  
The Relationship ◽  
Satisfaction With Family Life

The present study analyzes the problem of finding the relationship between the level of marriage satisfaction and the peculiarities of the social and psychological attitudes of modern spouses. The motivational orientation of modern spouses has been analyzed. It has been shown that the highest level of marriage satisfaction is observed in “families with adolescents”, the lowest level – in “mature families”. The interpersonal dealings between the spouses have been revealed and the most important factors that negatively affect the marriage have been singled out, which include: lack of emotional support, inflated expectations of marriage, dissatisfaction with the character of the spouse. It is shown that the more similarity in relation to important areas of life and common motivational orientations and needs the spouses have, the more level of satisfaction with family life they obtain. The similarity of characters and the presence of similar values in spouses keep the family together. In contrast, the sharp divergence between the real character of the spouse and the expectations from him/her is the most influential factor that determines low marriage satisfaction.

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