Communication Of Bad News Research Articles

Validity and Reliability Study of the Questionnaire on Communicating Bad News for Healthcare Professionals Adapted into Turkish

Objective: In this study, it was aimed to make a validity and reliability study by adapting the questionnaire on communicating bad news to be used to evaluate the knowledge and skills of nurses and midwives in breaking bad news. Methods: The questionnaire adaptation study was carried out in a gynecology and obstetrics hospital between 15/05/2022 and 15/012/2022. The questionnaire was translated into Turkish and then expert opinion was obtained. Cronbach's alpha coefficient was used for the reliability of the questionnaire. The stability of the questionnaire over time was evaluated by test-retest. For the purpose of construct validity of the questionnaire, exploratory factor analysis was used. SPSS 17.00 and AMOS programs were used for the validity and reliability analyzes of the questionnaire. Results: The Cronbach Alpha value of the 21-items final version of the questionnaire (n=262) was 0.87. Intraclass Correlation Coefficient value was 0.95 (n=21) and Cronbach's alpha coefficient was 0.97 (P<.001). Five components were obtained, which explained 53.631% of the variance of the questionnaire. Total score obtained from the questionnaire was 55.10 ±5.53 (min=35, max=63). Conclusion: As a result of the evaluation of multiple the fit indices, it showed that the Communicating Bad News Questionnaire was statistically significant, valid and reliable for nurses and midwives.

Strategies used to deliver bad news to the family of unexpected and sudden death victims: a scoping review protocol

Objective: This scoping review aims to map the strategies used during the communication of bad news to families of unexpected and sudden death victims from the perspective of those receiving the news. Introduction: The strategies used in communicating a person’s death to their family, especially in unexpected and sudden situations, can have a profound impact on the grief management process. This communication is often carried out by a health professional (doctor, nurse, or paramedic), but may also be carried out by a police officer, depending on the context in which the situation has occurred (in or out of hospital). Inclusion criteria: This scoping review will include studies on families of victims of unexpected and sudden death. All studies focusing on the strategies used to communicate bad news of unexpected and sudden death face to face, implemented by any professional in an intra-hospital or extra-hospital context, from the perspective of those who received the news, will be considered. Methods: The JBI methodology for scoping reviews will be followed. An initial search will be conducted, followed by a second search for published and unpublished studies in major health-related electronic databases. Studies published in English, Spanish, French, and Portuguese will be included, with no geographical, cultural, or time limits. Data selection, extraction, and synthesis will be performed independently by 2 reviewers and will include details of populations, study methods, and strategies used. A narrative synthesis will accompany the results and describe how they relate to the objectives of the review. Review registration: Open Science Framework https://osf.io/4rhw3

Experience as a physician attending to traffic accident victims in hospitals in Managua, Nicaragua

Introduction: Every 23 seconds a person dies from a traffic accident in the world, that is about 3756 deaths per day, with the consequent impact on relatives and health personnel. Doctors are part of the health team that is on the front line of care. Although this is part of their daily work, their feelings and emotions are deeply affected. There is a deficit of research of this type carried out by doctors.Methodology: Qualitative study, under the constructivist paradigm with a phenomenological approach. The objective was; explore the lived experience of doctors who treat victims of traffic accidents. The sample was intentional with five participating physicians . The phenomenological interview was used as an information collection technique and analyses were carried out according to Van Manen.Results: From the analysis, 15 codes were obtained inductively, which gave rise to 6 sub-themes: Impacts of Tragedies; Communication of bad news; Becoming of emotion; Coping; Narratives that endure and Resignation that in turn made up the 3 central themes: Body Lived in the impact, Time Lived in the here and after and Human Relations lived: between narratives and resignation.Conclusion: The study reveals that doctors are indirect victims of adverse events in the face of damage to the patient and their family in the face of a traffic accident. Constant monitoring of their psychological and emotional well-being, training communication strategies and improving patient-centered curricular programs are recommended. Extending the study to other specialties would enrich this understanding..

Contributions of the Communication and Management of Bad News in Nursing to the Readaptation Process in Palliative Care: A Scoping Review

Background: Delivering bad news is a sensitive and challenging aspect of nursing healthcare, requiring a holistic approach that respects patients’ preferences, cultural values, and religious beliefs to promote adaptation to the person’s state of health. Aim: We aim to map the evidence of the dimensions present in the communication and management of bad news by nurses to a person in a palliative situation, their caregivers, and their family members. Methods: Based on the Joanna Briggs Institute methodology, the search was conducted through MEDLINE Complete (EBSCOhost), CINAHL Complete (EBSCOhost), SciELO, and the Open Access Scientific Repository in Portugal. From a total of 756 articles, 14 were included, published between 2018 and 2023. Results: Structure components in bad news are influenced by the characteristics of the palliative patients, their caregivers, their family members, the nurses, and the organizational environment. Promoting the quality of the communication process is desirable through continuous and advanced training in end-of-life care, training in bad news, religiously and culturally sensitive nursing interventions centered on hope and maintaining faith, emotional management, and the utilization of a checklist protocol. Conclusions: Honest communication allows people to actively participate in the decision-making process and in the trajectory of the care plan that is focused on themselves and their preferences, which has outcomes in functional capacities and readaptation.

Communication of bad news in palliative care: bibliometric study

Communication of bad news in palliative care: bibliometric study

Interpretation of bad news delivery in medical practice through PRISMA 2020 literature review

Poor communication of bad news can have a significant negative impact on patients, triggering stress, anxiety and deterioration in their overall health status. The aim of this study was to interpret the delivery of bad news in medical practice through a literature review for the proposal of an approach to improve effective communication skills among health professionals. To achieve this end, a literature review was conducted following the guidelines of the PRISMA 2020 methodology, using sources such as PubMed, Lilacs and Scielo. From this search, 16 articles relevant to the topic of study were selected. The findings underline that the ability to adequately communicate bad news is not optional, but an essential competency within professional practice, thus highlighting the importance of this topic in the medical setting. It is concluded that it is crucial for health professionals to be adequately prepared to communicate bad news, which implies the development of protocols and specific recommendations on prognosis and treatment, and the fostering of a doctor-patient relationship based on trust and mutual respect

Cancer patients' preferences for communication of bad news: A systematic review of measurement properties

Cancer patients' preferences for communication of bad news: A systematic review of measurement properties

Estratégias de comunicação enfermeiro-paciente: proposta de um vídeo educativo para estudantes de enfermagem

Objective: to create, validate and evaluate an educational video on nurse-patient communication strategies for undergraduate Nursing students. Method: this is a methodological study with a longitudinal design and quantitative analysis. The following stages were conducted: pre-production, production, post-production and evaluation of the video by the target population. Results: five female nurses evaluated the video storyboard and indicated understanding of the subject matter, the topics addressed and the language used as adequate and pertinent to the theme. Another five female nurses considered the following as present and desirable elements: quality of the audiovisual technique employed, simulated environment, characterization of the characters, and development of the nurse-patient communication strategies The final version of the video was evaluated by nine Nursing students that presented a level of item understanding of at least 96%. The video presents the following strategies: General communication strategies, Intercultural Communication, NURSE, Tell me more, Ask-Tell-Ask, Therapeutic Communication and Communicating Bad News. Conclusion: this study portrays the creation of a video, its validation by experts and its evaluation by the target population, which indicated it as a relevant educational resource for the teaching-learning process regarding communication strategies. Both the evaluators and the target population considered that the video is a valid instrument to teach content about the nurse-patient communication strategies.

Nurse-patient communication strategies: A proposal of an educational video for Nursing students.

to create, validate and evaluate an educational video on nurse-patient communication strategies for undergraduate Nursing students. this is a methodological study with a longitudinal design and quantitative analysis. The following stages were conducted: pre-production, production, post-production and evaluation of the video by the target population. five female nurses evaluated the video storyboard and indicated understanding of the subject matter, the topics addressed and the language used as adequate and pertinent to the theme. Another five female nurses considered the following as present and desirable elements: quality of the audiovisual technique employed, simulated environment, characterization of the characters, and development of the nurse-patient communication strategies The final version of the video was evaluated by nine Nursing students that presented a level of item understanding of at least 96%. The video presents the following strategies: General communication strategies, Intercultural Communication, NURSE, Tell me more, Ask-Tell-Ask, Therapeutic Communication and Communicating Bad News. this study portrays the creation of a video, its validation by experts and its evaluation by the target population, which indicated it as a relevant educational resource for the teaching-learning process regarding communication strategies. Both the evaluators and the target population considered that the video is a valid instrument to teach content about the nurse-patient communication strategies.

Communication strategies used by medical physicians when delivering bad news at the Maputo Central Hospital, Mozambique: a cross-sectional study

BackgroundPhysicians’ communication with patients and their families is important during both the disease diagnosis and prognosis stages and through the follow-up process. Effective physician communication improves patients’ quality of life and satisfaction with care and helps reduce suffering for those newly diagnosed with advanced progressive illnesses. This study aims to identify the communication strategies physicians use in the transition to palliative care and how these professionals perceive their academic and clinical preparation concerning this task.MethodsA cross-sectional and quantitative study. Physicians providing palliative care at the Maputo Central Hospital, Mozambique, were invited to complete a 17-question questionnaire. This questionnaire was based on a Brazilian adaptation of the Setting-Perception-Invitation-Knowledge-Emotions-Strategy (SPIKES) tool, the P-A-C-I-E-N-T-E protocol, with additional questions regarding socio-demographic details and the integration of “communication of bad news” into hospital training.ResultsOf the 121 participants, 62 (51.2%) were male, and 110 (90.9%) were general practitioners, with a median age of 36 years old. They had worked in clinical practice for a median of 8 years and in their current department for three years. The majority of the participants considered that they have an acceptable or good level of bad news communication skills and believed that they do it in a clear and empathic way, paying attention to the patient’s requests and doubts; however, most were not aware of the existing tools to assist them in this task and suggested that delivering bad news ought to be integrated into the undergraduate medical course and included in hospital training.ConclusionsThis study adds to our understanding of physicians’ strategies when communicating bad news in the context of palliative care at one Mozambique hospital. As palliative care is not fully implemented in Mozambique, it is important to use protocols suitable to the country’s healthcare level to improve how doctors deal with patients and their family members.

Powerful medical education improves health care quality and return on investment

Introduction Powerful medical education (PME) involves the use of new technologies informed by the science of expertise that are embedded in laboratories and organizations that value evidence-based education and support innovation. This contrasts with traditional medical education that relies on a dated apprenticeship model that yields uneven results. PME involves an amalgam of features, conditions and assumptions, and contextual variables that comprise an approach to developing clinical competence grounded in education impact metrics including efficiency and cost-effectiveness. Methods This article is a narrative review based on SANRA criteria and informed by realist review principles. The review addresses the PME model with an emphasis on mastery learning and deliberate practice principles drawn from the new science of expertise. Pub Med, Scopus, and Web of Science search terms include medical education, the science of expertise, mastery learning, translational outcomes, cost effectiveness, and return on investment. Literature coverage is comprehensive with selective citations. Results PME is described as an integrated set of twelve features embedded in a group of seven conditions and assumptions and four context variables. PME is illustrated via case examples that demonstrate improved ventilator patient management learning outcomes compared to traditional clinical education and mastery learning of breaking bad news communication skills. Evidence also shows that PME of physicians and other health care providers can have translational, downstream effects on patient care practices, patient outcomes, and return on investment. Several translational health care quality improvements that derive from PME include reduced infections; better communication among physicians, patients, and families; exceptional birth outcomes; more effective patient education; and return on investment. Conclusions The article concludes with challenges to hospitals, health systems, and medical education organizations that are responsible for producing physicians who are expected to deliver safe, effective, and cost-conscious health care.

(170) Delivering Care and Communicating Bad News in the Age of Open Notes: When the Chart Shares Diagnoses Before the Doctor Can

(170) Delivering Care and Communicating Bad News in the Age of Open Notes: When the Chart Shares Diagnoses Before the Doctor Can

Examining Saudi Physicians' Approaches to Communicate Bad News and Bridging Generational Gaps.

Breaking bad news is an intrinsic aspect of physicians' clinical practices. This study aims to investigate how Saudi physicians manage the process of communicating bad news and explore potential differences in breaking bad news practices between young physicians (interns) and their older colleagues. From 1 March to 15 April 2023, ok an anonymous online cross-sectional survey was conducted to explore the communication practices of Saudi physicians concerning breaking bad news using the Communicating Bad News Questionnaire. The physicians were recruited through convenience and snowball sampling methods, and the survey questionnaire was distributed on various social media platforms, including Facebook, Twitter, LinkedIn, and WhatsApp. Data were analyzed using R version 4.2.1. A total of 782 physicians were included in this study. Male physicians represented 50.9% of the participants. Three-quarters (74.7%) were aged 25-30 years. The largest proportion of physicians (45.3%) were interns, followed by junior residents (22.9%), senior residents (11.0%), and specialists (6.5%). The median years of experience was 1.0, ranging from 0 to 45 years. Regarding the place of work, most physicians (86.6%) worked in hospitals, while 13.4% worked in primary healthcare centers. A total of 14.8% said they were not comfortable with discussing patients'/relatives' issues (20.60 among interns vs. 10.50% among non-interns, χ2 = 27.50, p = 0.0001), 66.6% reported being trained to break bad news (59.60% among interns vs. 72.40% among non-interns, χ2 = 14.34, p = 0.001), 59.1% reported breaking bad news to the patient, 37.9% reported to the family, and 3.1% reported to both, with no significant difference between interns and non-interns. A substantial proportion of physicians reported feeling uncomfortable discussing sensitive issues with patients and their relatives despite having received training to deliver bad news and being willing to communicate bad news directly to patients. Notably, our analysis identified a significant disparity between intern and non-intern physicians, particularly in terms of their comfort level in addressing patient-related concerns and access to breaking bad news training.

Communication and shared decision-making after stillbirth: Results of the ShaDeS study

BackgroundShared decision-making (SDM) is included in guidelines for bereavement care after a stillbirth, as it can improve women’s long-term health and wellbeing. SDM within the stillbirth context is still not common, and Italy does not yet have standardised guidelines. AimThe ShaDeS (Shared Decision-Making in Stillbirth) study aims to investigate how Italian women with a stillbirth perceive their own centrality in decision-making processes around bereavement care and how this might impact satisfaction of care. MethodsThe ShaDeS study is a cross-sectional study based on a web survey consisted of four sections: sociodemographic information and medical history, communication of bad news and bereavement care, decisions about childbirth (SDM-Q-9, SHARED, and DCS), and decisions and communication about autopsy (CPS). Findings187 women answered the survey. For the 41.1% of women that did not have an emergency childbirth, the SDM-Q-9 median score was 66.6 (0–100 range), and the SHARED median score was 3.5 (1–5 range). 29.4% of participants reached the proposed cutoff of 37.5 in the DCS (0–100 range) suggesting a difficulty in reaching decisions. Satisfaction scores were lower for those with such difficulties (p < 0.0001). Of the 64.5% of women that discussed autopsy, 28.3% were involved in an SDM approach, despite this being associated with higher levels of satisfaction of care (p < 0.05). ConclusionAn SDM approach is only moderately widespread amongst our participants, despite it being significantly related to higher levels of satisfaction. Further studies should investigate the tools that both patients and healthcare professionals need for an SDM approach.

The Communication of Bad News in Palliative Care: The View of Professionals in Spain.

Communication is one of the central axes around which end-of-life care revolves in the context of palliative care. Communication of bad news is reported as one of the most difficult and stressful tasks by palliative care professionals. Therefore, the aim of this study is to identify aspects related to the communication of bad news in palliative care in Spain. Descriptive cross-sectional study. An ad hoc questionnaire was designed and sent by e-mail to all palliative care teams in Spain. Overall, 206 professionals (102 nurses, 88 physicians and 16 psychologists) completed the questionnaire. A total of 60.2% considered their communication of bad news skills to be good or very good. This was related to older age, experience in both the profession and palliative care, and to having received specific postgraduate training (P < .001). Around 42.2% perform communication of bad news with the patient first, which is associated with lower skill (P = .013). About 78.15% of the professionals do not use any specific protocol. This study suggests that patients access palliative care with little information about their diagnosis and prognosis. The barriers identified in the communication of bad news are the lack of specific education and training in protocol management, the difficult balance between hope and honesty, the young age of the patient, and the family.

O.O.2.1Development and evaluation of a class on bad news communication for medical students: Presenter(s): Paulo Vitoria, Beira Interior University, Portugal

O.O.2.1Development and evaluation of a class on bad news communication for medical students: Presenter(s): Paulo Vitoria, Beira Interior University, Portugal

Breaking Bad News During the COVID-19 Pandemic: A Systematic Review of the Literature.

The aim of the present review was to extend research by reviewing international research regarding the communication between oncologists and oncology patients and the communication of bad news to oncology patients during the COVID-19 pandemic. Following the PRISMA guidelines a review of the literature was performed by searching PubMed, Scopus, and EMBASE bibliographic databases from inception to October 10, 2022. The search was limited to articles written in English. Two reviewers independently completed title and abstract, full-text screening, and data extraction. A total of five studies were deemed eligible for this systematic review. A narrative synthesis was undertaken. Of these five articles, three referred to the communication of bad news to patients by medical oncologists during the COVID-19 pandemic, whereas the remaining two referred to the transmission of bad news to patients by surgeons during the pandemic. The COVID-19 pandemic and the social distancing measures imposed caused radical changes in the forms of communication in medical environments. The challenges faced by the oncologist in breaking bad news to cancer patients are highlighted in this systematic review, and the need for physician preparation prior to communication with the patient is emphasized. Overall, new studies are needed on the effects of distance communication on both health professionals and patients. New studies are also needed that would explore the perceptions of physicians and patients in Greece.

Comunicação de más notícias em unidade de terapia intensiva neonatal

Abstract The SPIKES protocol is one of the most didactic tools to teach the communication of bad news, a skill that requires sensitivity and preparation. This article analyzed the perceptions of pediatrics residents and the mothers of neonates about the communication of bad news in a neonatal intensive care unit. This is a qualitative, descriptive and exploratory study, based on visual anthropology, in which the SPIKES protocol was used in two focus groups, with Bardin’s content analytics approach by categories. Problems were reported as inadequate environment to break bad news, limitations in the perception of mothers, lack of medical availability to talk, inadequate language and difficulty to deal with emotions, clarify doubts and discuss strategies with family members. Reflection on these issues aims to improve theoretical learning and stimulate self-criticism, seeking empathy and the humanization of care.

The barriers dentists face to communicate cancer diagnosis: self-assessment based on SPIKES protocol.

This study aimed to characterize the barriers faced by Brazilian dentists to deliver bad news (DBN) about oral and oropharyngeal cancer diagnoses to patients by using a questionnaire based on the guidelines of the SPIKES protocol. This was an observational cross-sectional study. The questionnaire contained 27 questions based on the SPIKES protocol, which were answered in the SurveyMonkey platform. A total of 186/249 dentists answered the questionnaire. The main specialties reported were 36.02% oral medicine, 21.5% oral pathology, and 9.13% oral and maxillofacial surgery. A total of 44.6% expressed concern about the patient's emotional reactions, and 46.24% of respondents had never participated in any specific training to communicate bad news. The lack of training and low confidence in dealing with patients' emotional reactions dentists were considered the greatest barriers to DBNs. Moreover, most dentists who participated in the survey believe that a protocol to guide the communication of bad news would be useful for clinical practice. For those protocols to be used by dentists, training is critical for these protocols to be incorporated by professionals.

Compreensão e comunicação de cuidados paliativos em neonatologia: abordagem bioética

Abstract Dealing with death and palliative care in neonatology is challenging for health professionals. This retrospective qualitative and descriptive study sought to understand the process of neonatal palliative care communication in a hospital in southern Brazil, analyzing the results from a bioethical perspective. Data were collected by semi-structured interviews, conducted with 14 participants (seven mothers and seven doctors) between June 2021 and August 2022, and examined using Bardin’s content analysis. Two categories stood out: knowledge about palliative care and communication in palliative care. In conclusion, existing communication obstacles can interfere with the family’s understanding of palliative care. Education on topics such as bioethics, palliative care and communication of bad news require greater investments to facilitate these processes and equip professionals.