Modifying “Breaking Bad News” Communication: Cross-Cultural and Cognitive-Semantic Approaches

Abstract

The paper addresses the alteration strategies to be implied by a health care professional in the situation of breaking bad news in terms of patient-centered paradigm applied to modern medical communication agenda. The investigation is based on linguistic analysis through semantic framing of “breaking bad news” situation and is specified by onomasiological and semasiological interpretations. The conventional cognitive perception of “breaking bad news” situation is realized as one predetermined by invoked framing. The diversification of 'SPIKES' protocol with optional implementation of a cultural component is regarded as an effective educational medium in cross-cultural medical settings. In the paper the latter is employed as a valuable tool for modification of the way the participants view the situation. The modified protocol implicates the properties to influence the prospective treatment pattern. The interdisciplinary nature of the study outlines the valuable grounding for the shift from the mutually expressed negative attitudes to situational consistency via evoked experience of the medical professionals.

Breaking bad news: patients’ perspectives of the information process in a general surgery outpatient clinic survey

“…However, among these details, the issue that requires clarification from the very outset is the determination of whom information concerning the patient will be shared with. Various protocols such as SPIKES, BREAKS and ABCDE have been developed to address the issue [26][27][28]. In some countries where these protocols are widely used, there are studies that outline objections, as well as some suggestions to address the shortcomings of these methods [15].…”

“…In such circumstances, which may also be affected by socio-cultural characteristics, a significant portion of the patients stated that this news should only be shared with them. Since poor prognosis commonly evokes negative views such as long-term nursing, death and despair, this issue has a direct link to religion, beliefs, and culture [26,30]. Therefore, it is often not surprising that a subject matter which involves social institutions and interactions, family or relatives may also be involved in the process.…”