Breaking Bad News: A contextual model for Pakistan

Baig, Lubna; Tanzil, Sana; Ali, Sajid; Shaikh, Shiraz; Jamali, Seemin; Khan, Mirwais

doi:10.12669/pjms.346.15663

Cited by 12 publications

(11 citation statements)

References 17 publications

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“…To our knowledge, the current study is the first study of its kind in Egypt. Breaking bad news is a common volatile situation that is potentially violence and require certain skills and approach to communicate and prevent its escalation into violence against HCPs [ 25 ]. This highlights the importance of conducting this training.…”

Section: Discussionmentioning

confidence: 99%

“…understanding trauma, neuroscience of threat and safety can help HCPs in understanding patients’ aggression and develop strategies to better cope with it [ 24 ]. Breaking bad news is a common volatile situation that is potentially violence and require certain skills and approach to communicate and prevent its escalation into violence against HCPs [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

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Patient and visitor aggression de-escalation training for nurses in a teaching hospital in Cairo, Egypt

et al. 2022

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Background Workplace violence (WPV) has been recognized as a major occupational hazard worldwide. Healthcare professions are particularly at a higher risk of WPV. Patients and their relatives are commonly the most common perpetrators for WPV against physicians. Trainings on the universal precautions of violence, how to effectively anticipate, recognize and manage potentially violent situation is recommended by OSHA as a part of a written, effective, comprehensive, and interactive WPV prevention program. Objective To implement and evaluate the effectiveness of a training session delivered to nurses. The training session aimed to increase nurses’ ability to identify potentially violent situations and to effectively manage these situations in a teaching hospital in Egypt. Methodology A total of 99 nurses attended the training sessions. Confidence in coping with aggressive patient scale, along with nurses’ attitudes toward WPV, were used to assess the effectiveness of the training sessions. Results Nurses’ perceived confidence to deal with aggression increased after attending the training sessions. Nurses’ attitudes toward WPV positively changed after attending the training session. Conclusion and recommendations Increasing awareness of the problem among healthcare professions as well as the public is warranted. Violence prevention program with a zero-tolerance policy is warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patient and visitor aggression de-escalation training for nurses in a teaching hospital in Cairo, Egypt

et al. 2022

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“…However, some literature has appeared over the last decade. This provides a contextual model for the subject [18] . The findings of Baig et al included a general recognition of the value of presenting bad news among clinicians.…”

Section: Discussionmentioning

confidence: 99%

Breaking bad news: a descriptive study of physicians’ perspective of Sindh, Pakistan

Abbas

Abbas²,

Mubeen

et al. 2022

J Pak Med Assoc

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Objective: To assess the perception and attitude of physicians related to breaking bad news. Methods: The cross-sectional study was conducted at three teaching hospitals in Karachi and Mirpurkhas, Pakistan, from April 2019 to February 2020, after approval from Hamdard University, Karachi, and comprised physicians of either gender having direct patient contact. Data was collected using a questionnaire based on literature. The questionnaire was pilot-tested before distribution among the subjects. The responses were categorised with respect to age, gender and professional experience. Data was analysed using SPSS 25. Results: Of the 230 subjects, 119(51.7%) were females. The overall mean age was 34.5±8.8 years and mean professional experience was 9.1±8.2 years. Overall, 19(8.3%) subjects believed they had a very good ability to deliver bad news, while 26(11.3%) avoided telling the patient the truth about diagnosis, prognosis and treatment. Age had a significant association with correctly defining breaking bad news (p<0.05). Conclusion: The skill level related to breaking bad news was found to be deficient. Key Words: Breaking bad news, Communication, Pakistan.

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“…A study from Pakistan explored the causes of violence against HCPs. The HCPs from different categories perceived impatience, lack of respect towards HCPs, unrealistic expectations from HCPs and hospital as the client related factors and bad attitude of HCPs towards patients and caretakers, lack of timely communication, inability to counsel caretakers and prepare for undesirable outcomes as the provider-related factors for the violence against HCPs [ 6 ]. The Italian parents perceived that their role as parents and the physical intimacy were compromised during the PICU period.…”

Section: Discussionmentioning

confidence: 99%

“…The efforts, attitude, behaviour and communication by the HCPs have impact on the acceptance and response from the parent and family. While in majority of the instances, the parents and family accept the bad news, there are instances of unpleasant reactions and violence against the HCPs and hospitals [ 6 ]. A study from India reported families dissatisfaction with the services, miscommunication and ineffective communication and death as the important reasons following the non-availability of medicines, facilities and manpower challenges in healthcare services [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Perceptions of the parents of deceased children and of healthcare providers about end-of-life communication and breaking bad news at a tertiary care public hospital in India: A qualitative exploratory study

et al. 2021

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Background Parents of dying children face unique challenge and expect compassionate support from health care providers (HCPs). This study explored the experiences of the parents and HCPs about the end-of-life care and breaking bad news and related positive and negative factors in Indian context. Methods This qualitative exploratory study was conducted at paediatrics department of a tertiary care hospital in Delhi. In-depth interviews with the parents (n = 49) and family members (n = 21) of the children died at the hospital and HCPs (6 doctors, 6 nurses and 4 support staffs) were conducted. Also events and communication around death of eight children were observed. Data were inductively analysed using thematic content analysis method to identify emerging themes and codes. Results Doctors were the lead communicators. Majority of parents perceived the attitude, communication and language used as by resident doctors as brief, insensitive and sometimes inappropriate or negative. They perceived that the attitude and communication by senior doctor’s as empathetic, positive and complete. Parents recalled the death declaration by resident doctors as non-empathetic, blunt and cold. Most parents received no emotional support from HCPs during and after death of their child. All doctors expressed that death of their patients affected them and their emotions, which they coped through different activities. The overcrowded wards, high workload, infrastructural limitation and no formal communication training added to the emotional stress of the HCPs. Conclusions Majority of the communication by the HCPs during the hospitalisation and end-of-life period were perceived as suboptimal by the parents. The HCPs were emotionally affected and faced end-of-life communication challenges. The study highlights the communication by HCPs and support for parents during the end-of-life communication and breaking bad news. It suggests adoption of context specific communication protocol and materials and training of HCPs in communication to improve the quality of care.

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Breaking Bad News: A contextual model for Pakistan

Cited by 12 publications

References 17 publications

Patient and visitor aggression de-escalation training for nurses in a teaching hospital in Cairo, Egypt

Patient and visitor aggression de-escalation training for nurses in a teaching hospital in Cairo, Egypt

Breaking bad news: a descriptive study of physicians’ perspective of Sindh, Pakistan

Perceptions of the parents of deceased children and of healthcare providers about end-of-life communication and breaking bad news at a tertiary care public hospital in India: A qualitative exploratory study

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