Single cases from multiple perspectives: a qualitative study comparing the experiences of patients, patients’ caregivers, surgeons, and nurses when bad news is delivered about cancer

Matthews, Tamyra; Baken, Donald; Ross, Kirsty

doi:10.1097/or9.0000000000000032

Cited by 7 publications

(18 citation statements)

References 25 publications

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“…Physicians may develop physiological stress responses and anxiety, particularly when they assess the conversation as ‘unsatisfactory’ (Shaw et al 2013 ; Friedrichsen and Milberg 2006 ). Especially for patients, as recipients of bad news, this moment is often highly emotional and overwhelming (Matthews et al 2020 ; Monden et al 2016 ). Retrospectively, patients and their families described the BBN situation as a ‘turning point’ or biographical caesura (Bumb et al 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Cancer patients’ experiences and preferences when receiving bad news: a qualitative study

Krieger

Salm

Dresen

et al. 2022

J Cancer Res Clin Oncol

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Purpose Receiving a cancer diagnosis significantly impacts patients’ lives, and how the bad news is delivered influences patients’ trajectory, psychosocial adjustment and openness to psycho-oncological support. We explored how patients’ experiences, reactions and preferences were when receiving the news and which optimization recommendations can be made. Methods We conducted an exploratory qualitative study with patients who enrolled in the new integrated cross-sectoral psycho-oncological care programme ‘isPO’, being enrolled 12 months post-diagnosis. Data on the main issue (i.e. perception of the moment when the diagnosis is received) were collected via telephone interviews that were fully audiotaped and transcribed. Two independent coders conducted inductive content analyses using MAXQDA. Results Out of 38 approached patients, 23 cancer patients with 13 different tumour entities participated. They had a mean age of 54.2 (SD 16.2); n = 17 (74%) were female. Three major themes with 14 corresponding subthemes emerged: (1) patients’ experiences with the bad news delivery, including setting, mode, preparation and perceived needs; (2) patients’ reactions to the bad news, such as shock, fear and helplessness, disbelief and denial, anger and feeling of injustice, thankfulness and depression; and (3) patients’ receiving preferences, including psycho-oncological support, addressing informational needs, needs-driven comprehensive support and a competent multidisciplinary support team. Conclusions The quality of bad news delivery and addressing patients’ needs should be strongly considered by physicians. We recommend integrating patients’ perspective on the quality management processes of breaking bad news. For providing needs-centred high-quality care, applying existing guidelines and acquiring patient-centred communication skills are central.

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Section: Introductionmentioning

confidence: 99%

Cancer patients’ experiences and preferences when receiving bad news: a qualitative study

Krieger

Salm

Dresen

et al. 2022

J Cancer Res Clin Oncol

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“…The ALS imagery of our participants highlights the need to enhance meaningful relationships within and outside the family, including the support of trusted and/or specialized people, such as doctors and psychologists. A need highlighted is communication, which has already been considered in the literature as a problematic dimension that requires special care [ 51 , 52 , 53 , 54 , 55 , 56 , 57 ]. Within this area, the theme of how to communicate the diagnosis of an illness with an unfortunate outcome to children has been particularly noteworthy.…”

Section: Discussionmentioning

confidence: 99%

“Imagine You Have ALS”: Death Education to Prepare for Advance Treatment Directives

Testoni

Palazzo

Calamarà

et al. 2021

Behavioral Sciences

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The study presents the results of qualitative research carried out within a death education project dedicated to advance treatment directives (ATDs) in which it was proposed to participants to empathize with people who had received a diagnosis of Amyotrophic Lateral Sclerosis (ALS). The study involved 104 people who discussed and reflected on issues related to the knowledge of having to die, palliative care and ATDs, investigating what choices they would have made if they had received such a diagnosis. Finally, they were asked to write a paper describing their impressions and hypothetical choices. Qualitative analysis has elucidated among fundamental themes. Four thematic areas emerged from the data analysis: (1) ATDs and the family; (2) the importance of reducing pain and suffering; (3) emotions and considerations regarding death, illness and spirituality; and (4) opinions on the DeEd course. It has emerged that some people are unfamiliar with palliative care or the right to self-determination and that addressing these issues helps manage the thought of the future with less terror. The experience of death education has therefore proven to be very positive in dealing with complex and often censored issues, allowing thinking about death in a less distressing way.

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“…(10) Since nurses have the largest workload and more contact with patients and family members, they are key players in the disclosure of bad news, and should establish an important bond at this moment. (30,31) Results of previous studies showed the creation of the nurse/patient bond is essential for a relationship of trust between them. (29,31) Therefore, even if it is not the nurses who communicate the bad news, their presence is fundamental to establish the necessary confidence to the patient and family, besides being the professionals who provide continuity of care to these subjects, and follows all consequences of the announced news.…”

Section: Englishmentioning

confidence: 99%

“…(8,11,25) Therefore, it is important to highlight that this communication must occur as a team, because even if it is the physician or the nurse who conveys bad news, there is a repercussion that reaches all other professionals who deal with the patient. (30) In communicating bad news in delivering comprehensive care, nurses are fundamental professionals who favor the establishment of a relationship of trust between the parties. This highlights the need to promote the development of communication skills of such professionals to ensure quality care.…”

Section: Englishmentioning

confidence: 99%

Communicating bad news in the practice of nursing: an integrative review

Agnese¹,

Daniel²,

Pedrosa³

2022

Einstein (São Paulo)

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Objective:To analyze current scientific knowledge about communication of bad news by nurses. Methods: This is an integrative literature review carried out by searching articles published in national and international journals indexed at SciELO, MEDLINE ® (PubMed ® ), Scopus, Bireme and CINAHL, from 2010 to 2020, by crossing the controlled descriptors "communication", "revelation of the truth", and "nursing", and the uncontrolled descriptor "bad news". Results: Ten articles with qualitative and cross-sectional design, as well as case reports were included. The analysis indicated the evidence available in the literature showed the nurses' lack of ability to communicate bad news, although they are professionals who have close contact with patients and families and who establish a strong bond with them, and often face challenging situations for communicating bad news. Conclusion: There is an evident need to invest in training of nurses on skills to communicate bad news and establish a nurse-patient bond when dialoguing with the family. There are few studies in the literature addressing this issue; therefore, it is recommended to perform research that can contribute to improvements in the clinical practice and developing protocols to promote such care.

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Single cases from multiple perspectives: a qualitative study comparing the experiences of patients, patients’ caregivers, surgeons, and nurses when bad news is delivered about cancer

Abstract: Supplemental Digital Content is available in the text

Cited by 7 publications

References 25 publications

Cancer patients’ experiences and preferences when receiving bad news: a qualitative study

Cancer patients’ experiences and preferences when receiving bad news: a qualitative study

“Imagine You Have ALS”: Death Education to Prepare for Advance Treatment Directives

Communicating bad news in the practice of nursing: an integrative review

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