Development and validation of The Breaking Bad News Attitudes Scale

Abstract

Background Communication of bad news plays a critical role in the physician-patient relationship, and a variety of consensus guidelines have been developed to this purpose, including the SPIKES protocol. However, little is known about physicians’ attitudes towards breaking bad news and to be trained to deliver it. This study aimed to develop and validate a self-report questionnaire to assess physicians’ attitudes towards principles of the SPIKES protocol and training on them. Methods The Breaking Bad News Attitudes Scale (BBNAS) was administered to 484 pediatricians and 79 medical students, recruited at two scientific conferences and two medical schools in Brazil. The questionnaire structural validity, reliability, and associations with other variables were tested. Results The BBNAS showed adequate validity and good reliability, with two factors measuring attitudes towards the SPIKES strategy for braking bad news (α = 0.81) and the possibility to be trained on it (α = 0.77), respectively. Conclusion The novel questionnaire is a psychometrically sound measure that provides information on physicians’ agreement with the SPIKES protocol. The BBNAS can provide useful information for planning training and continuing education programs for clinicians on communication of bad news using the SPIKES as a framework.

Time-critical telephone conversations in the emergency department: lessons learnt from a pilot educational project to improve communication skills over the telephone in response to the COVID-19 global pandemic

“…With most people using mobiles, there are many anecdotal stories of patients having bad news being broken while driving, shopping and at the gym. All BBN teaching emphasises the need for language and tone to be sympathetic and empathic 1 6 7 10 11. In face-to-face conversations, the physician can use body language or offer tissues or a cup of tea, but with telephone calls, tone and language are the only thing one has.…”

“…The actors found it useful for helping to build rapport with someone they had not met as it felt as if the clinician was really trying to understand what was going on. These questions can also provide insight in to the relative’s emotional state 10 11…”

“…BBN recommendations all suggest that the physician deliver a ‘warning shot’, which allows the receiver of the news to be prepared 4 6 7 10–13. The ‘relatives’ found this even more important over the telephone.…”

Comunicación de Malas Noticias

“…Una mala noticia puede alterar significativamente el futuro de un paciente, así sea temporal o para toda la vida. Dar malas noticias es parte importante de la cotidianidad de la práctica del médico (8). Transmitir malas noticias conlleva una carga emocional para los pacientes y sus familiares; así también para los médicos (9).…”

Behavioral Patterns in Breaking Bad News Communication: An Ethnographic Study with Hematologists

“…Some researchers have called for formal training in communication skills and targeted interventions for patients with hematologic malignancies from palliative care staff [ 4 , 19 ]. While in oncology [ 20 , 21 ] and palliative care [ 22 , 23 ], studies have been conducted on training healthcare professionals concerning the communication of bad news—including the implementation of protocols and guidelines to make such communication more efficacious [ 24 , 25 , 26 ]–to the best of our knowledge, evidence concerning hematologists’ skills, communicative behaviors and educative needs in this context is scarce.…”