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

2018 ◽  
Vol 48 (4) ◽  
pp. 340-344 ◽  
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.

scholarly journals Breaking bad news of cancer diagnosis - the patient’s perspective

2017 ◽  
Vol 5 (4) ◽  
pp. 1617 ◽  
Author(s):  
Amod S. Dhage ◽  
Anne R. Wilkinson
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Bad News ◽  
Fundamental Aspect ◽  
Junior Resident ◽  
Breaking Bad News ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Patient’S Perspective ◽  
Common Diagnosis

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.

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.

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

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.

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

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.

scholarly journals Perspectives of Protocol Based Breaking Bad News among Medical Patients and Physicians in a Teaching Hospital, Ethiopia

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Henok Fisseha ◽  
Wudneh Mulugeta ◽  
Rodas A Kassu ◽  
Temesgen Geleta ◽  
Hailemichael Desalegn
Keyword(s):  
Patient Satisfaction ◽  
Patient Preference ◽  
Clinical Care ◽  
Communication Process ◽  
Bad News ◽  
Breaking Bad News ◽  
Medical Patients ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Communication Task

BACKGROUND፡ Discussing potentially bad outcomes is a standard communication task in clinical care. Physicians’ awareness on ways to communicate bad news is considered low. SPIKES protocol is the most popular strategy used by physicians, but its practice and patients' perception are not known. This study attempted to fill the knowledge gap on protocol implementation, patient preference and physician effects.METHODS: Hospital-based descriptive cross-sectional study was conducted at SPHMMC from May 1 to June 30 using structured interviews administered to patients and physicians. Three hundred and sixty patients and 111 physicians were included. Assessment of SPIKES performance, patient satisfaction, patient preference, and physician awareness, attitude and effects were studied.RESULTS: Performance of SPIKES protocol was setting (74.5%), perception (51.1%), invitation (56.3%), knowledge (15.9%), emotion (22.3%) and summary (10.1%). Only 30.6% of the patients were entirely satisfied with the interaction, and 19.2% with knowledge attained. Patient satisfaction was associated with physician asking how much information they like (P=0.025). Patient desire and report showed variation. Eighty-two percent of the physicians were not aware of the protocol, and 83.8% had no training. Half of the physicians feel depressed after disclosure.CONCLUSIONS: Patient satisfaction with communication process and knowledge is poor, as is performance of SPIKES components. Satisfaction is related to being asked how much patients want to know. Patients’ desires on how to be told news is different from how it is done. Breaking bad news increases feeling of depression. Awareness and training on the protocol are deficient; medical schools should incorporate it into their studies and implement proper follow-up. 

scholarly journals Breaking Bad News in Cancer Care: Ethiopian Patients Want More Information Than What Family and the Public Want Them to Have

2021 ◽  
pp. 1341-1348
Author(s):  
Aynalem Abraha Woldemariam ◽  
Rune Andersson ◽  
Christian Munthe ◽  
Barbro Linderholm ◽  
Nataliya Berbyuk Lindström
Keyword(s):  
Family Caregivers ◽  
General Public ◽  
Information Disclosure ◽  
Public Perception ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Bad News ◽  
Breaking Bad News ◽  
Cross Sectional ◽  
Breaking Bad

PURPOSE This study explores the preferences of patients with cancer, family caregivers, and the general public regarding breaking bad news in an Ethiopian oncology setting. METHODS The study was conducted at Tikur Anbessa (Black Lion) Specialized Hospital. The sample consists of patients with a confirmed cancer diagnosis, their family caregivers, and representatives from the general public with 150 subjects per cohort. The study used a comparative cross-sectional design and multivariable data analysis. RESULTS The patients would like to be informed, which contradicts the preferences of family caregivers. This creates an ethical dilemma for staff in terms of how much they involve their patients in clinical decision making. The patients also indicate that information should not be withheld from them. By contrast, the general public prefers information about poor life expectancy to be communicated to family only, which may reflect a widespread public perception of cancer as a deadly disease. CONCLUSION The findings indicate the complexity of communication-related preferences concerning breaking bad news in oncology care in Ethiopia. It requires oncologists to probe patient attitudes before information disclosure to find a balance between involving patients in communication at the same time as keeping a constructive alliance with family caregivers.

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

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.

scholarly journals Evaluation of emergency medical services staff knowledge in breaking bad news to patients

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052091869
Author(s):  
Paweł Rasmus ◽  
Elżbieta Kozłowska ◽  
Katarzyna Robaczyńska ◽  
Krzysztof Pękala ◽  
Dariusz Timler ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Work Experience ◽  
Medical Personnel ◽  
Bad News ◽  
Medical Services ◽  
Breaking Bad News ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Emergency Medical

Objective The aim of the study was to investigate knowledge of breaking bad news (BBN) among medical personnel in the emergency medical services (EMS). Methods A cross-sectional survey was conducted of 148 individuals employed in EMS. An interview was conducted using a structured questionnaire. Results Of study participants, 89.2% were not aware of any formal BBN procedure and 58.1% had not participated in any form of training. Compared with males, females were more likely to report that dealing with the emotional state of the family or the patient was the most difficult aspect of BBN. Only a few participants were aware of the SPIKES protocol for BBN, and none knew what the acronym meant. Sex, educational level, occupation, work experience and workplace were not associated with knowledge of BBN procedures. Conclusions Knowledge of BBN in both male and female EMS staff was insufficient. EMS personnel held different opinions about the method of BBN. Even staff who have participated in specific BBN training or have extensive professional experience were pessimistic about BBN skills in self-assessments.

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