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

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.

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 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 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 An Overview of Teaching Communication of Bad News in Medical School: Should a Lecture be Adequate to Address the Topic?

2016 ◽  
Vol 29 (12) ◽  
pp. 826 ◽  
Author(s):  
Filipe Coutinho ◽  
Anisha Ramessur
Keyword(s):  
Online Survey ◽  
Descriptive Analysis ◽  
Daily Practice ◽  
Bad News ◽  
Breaking Bad News ◽  
Step Method ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Combination Approach ◽  
Delivering Bad News

Introduction: Delivering bad news is very common in medical daily practice. Several studies have shown a lack of effective communication skills amongst medical students, particularly concerning how to deliver bad news. The SPIKES protocol allows communicating bad news in a 6-step method. The aim of this study is to investigate the perspective of students related to this subject.Material and Methods: A 45 minute lecture “Breaking Bad News” was given to 160 students in the fifth and sixth years of the Medicine course, using the SPIKES’ protocol training. After the lecture, an online survey was given to all students, and a cross-sectional and descriptive analysis of data extracted from survey was undertaken.Results: Fifty-four students (21% of overall) answered the online survey. Eighty three percent said that theme should have an important role in their further daily medical practice, and most of students rated the physicians’ role as challenging. Sixty percent of students expressed that communicating bad news was an integral part of the medical course curriculum. Regarding the SPIKES´ protocol, 48% felt that the first step would be the easiest to put in practice, and 40% felt that the fifth step related to “Emotions” would be the most difficult.Discussion: In general, the students would like to gain competencies in breaking bad news using a practical approach Conclusions: Students highly valued theoretical and practical approaches in teaching of communication of bad news. Therefore, we encourage a combination approach in pre-graduate medical education.

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

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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