Breaking Bad News: A Valid Concern among Clinicians

Abstract

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.

The Way of Breaking Bad News by Nurses: A Report from Guilan Academic Hospitals

“…Also, it developed a greater capacity for treating others with respecting and understanding of requirements in palliative care nursing (20). Moreover, similar to Biazar et al (16), we found that age and years of experience were positively correlated with higher scores. Overall, these results show that therapeutic teams, including physicians and nurses, should act better based on their experience, not according to educational programs, a thought-provoking finding that needs special attention.…”

“…Biazar et al found that only 19.1% of faculty members and residents of GUMS had the belief that it is the patients' right to know about their exact survival time. In this study, this belief was even less probable, and only 17.7% of the nurses had the perspective of being honest about this topic (16).…”

“…In similar research on physicians working in academic hospitals, 86.4% of them were not educated on the issue of BBN, but still for 13.6% of them, participation in educational courses had no significant effect on the individuals' point of view regarding the way of BBN (16). It uncovers that the current curriculum is not effective enough and has to be revised.…”

Breaking Bad News During COVID-19 Time in Surgical, Emergency and Medical Specialties - What More we Need to Develop?

“…It has been shown that patients' preferences on the way to break bad news vary from those of the physicians ( 3 ). Patients prefer to obtain clear information about the progression and prognosis of disease, as well as about anticipated life expectancy, while in practice this information are not easily provided in clear terms.…”

Significados atribuídos por psicólogos hospitalares às relações entre profissionais de saúde na comunicação de más notícias

“…Ocorre que, por sua natureza relacional, a comunicação de más notícias não pode ser reduzida a um procedimento fundamentado em um único saber especializado, conforme adverte Krieger (2017). Na rotina de hospitais brasileiros, todavia, comumente médicos são os únicos responsáveis por tal atividade, embora não se sintam capacitados para tanto por compreenderem que não conseguem responder adequadamente às questões emocionais suscitadas pela ação comunicacional (Biazar et al, 2019;Vogel et al, 2019;Monteiro & Quintana, 2016).…”