Showing 7 results for Bad News
Mojtaba Parsa, Alireza Bagheri, Bagher Larijani,
Volume 4, Issue 6 (12-2011)
Abstract
Breaking bad news to the patients does not back to a long history and is a controversial issue between patients and physicians. Many physicians are reluctant to breaking bad news to patients and this is not desirable for most patients. For example, in Northern European countries and United States, most physicians usually break bad news to the patients, while in Southern and Eastern European countries or many Asian countries they would not do so. In Iran, physicians prefer to break bad news to patient's family rather than the patient. Cultural differences also influence people's viewpoints about breaking bad news. In Western countries, most people agree with breaking bad news to patients while it is not common in the other populations. Nowadays, the dominant view in the most countries is that it is the duty of the physicians to break bad news to patients. Some advantages of breaking bad news to patients including strengthening the trust between physician and patient, preventing non - maleficience, increasing patients satisfaction and reducing legal action against the doctors. There are some exceptions to breaking bad news the most important is serious psychological damage to the patient. Quality and quantity of information that should be released depends on situation of each patient. Breaking bad news needs specific communication skills and physicians must be trained for this purpose.
Sayyed Esmaeil Managheb, Masoumeh Hosseinpour, Fatemeh Mehrabi,
Volume 6, Issue 4 (10-2013)
Abstract
Breaking bad news is an unavoidable part of the medical profession, and doctors and patients stand at the two sides of this function. There are different views about how to break bad news in different cultures and societies. In this study we assessed the viewpoints of hospitalized patients on how to break bad news.
This cross sectional study was performed in 2011 at the Jahrom University of Medical Sciences. Sample size of 110 patients was calculated and the method of sampling was simple random sampling. Target population was the hospitalized patients of Peymanyeh and Motahari hospitals in Jahrom. Entry criteria consisted of being admitted to the above hospitals, and exclusion criteria included severely ill patients and patients with mental disorders. A reliable self-administered questionnaire was designed and validated. The questionnaires were completed and returned by 110 patients. Data were analyzed using the SPSS16 software through descriptive analysis. One hundred and ten patients were included in this study. The factor analysis showed three elements: methods of breaking bad news, the people involved in the breaking bad news process, and timing and location. Of participants 78% wanted to be told the bad news while their relatives were present, 63.2% wanted to be told the bad news in a private and quiet room. Almost all respondents emphasized the need for religious advisors and psychological counselors (77.2% and 62.5% respectively). Most of participants (91.5%) wished to receive all the information about the etiology of their disease, and 74.8% of them wanted to be told whether their illness was cancer.This study showed that there are different views on how to break bad news in different cultures and societies. Social and cultural differences must be considered in breaking bad news. In our country, patients’ families could have a prominent supporting role in the delivery of bad news to patients.
Manijeh Seresht, Ahmad Izadi,
Volume 6, Issue 4 (10-2013)
Abstract
Breaking bad news emotionally affects both health professionals and patients. Breaking bad news is a sensitive issue for both health care providers and patients. It is generally believed that the patient’s adjustment can be affected by either a positive or a negative experience in this respect. This study aims to determine health care providers’ attitudes toward breaking bad news to parents in NICU and labor wards.This cross-sectional study was conducted in Shahrecord in 2011 with a study sample of 70 health care providers drawn from neonatal intensive care units and labor wards and the department of nursing and midwifery who had had at least one year’s clinical experience. The sampling method was census. Data were collected through a self-administered questionnaire in two sections: demographic information and health care providers’ attitudes toward breaking bad news. Data were analyzed by SPSS software with descriptive and Chi-square and T-student test statistics.
Most participants (63.2%) had a positive attitude toward disclosing bad news to parents. 77.6% of caregivers faced difficulties in delivering bad news to parents, 92.6% of them believed that training workshops in this field are necessary. There was a significant statistical relationship between the attitudes of the health care providers and their education level and work place (P < 0.0001). Health professionals with higher education levels and nursing and midwifery staff had more positive attitudes.There was no significant statistical relationship between the attitudes of the health care providers and their history of difficulties in transferring bad news, workshop trainings, work experience, gender, age and marital status (P > 0.05). The majority of health professionals had a negative attitude toward immediate disclosure of bad news to parents, mothers holding and seeing their deceased babies, dedicating a special room to perinatal loss mothers with similar problems, and preventing other patients and their families from contacting them.Based on the findings of this study, teaching bad news communication skills to personnel of NICU and labor wards should receive prioritization in future continuing medical education programs in order to best prepare the staff for disclosure of bad news to parents.
Ali Labaf, Amirhossein Jahanshir, Amir Amir Shahvaraninasab,
Volume 7, Issue 1 (5-2014)
Abstract
Breaking bad news is one of the most difficult tasks an emergency physician has to perform and unfortunately it is not well studied. Almost all of the original studies for compilation of the guidelines of breaking bad news have been conducted in a non-emergent situation and were physician-oriented. In this study and by reviewing related articles in medical databases, the authors try to show the necessity of adapting these guidelines into the situation of the emergency departments and indigenizing them for non-Western countries. This can be the first step to design a guideline for the emergency department.The different nature of bad news and the chaotic situation in the emergency departments are the two most important points that may prevent using these guidelines in the emergency departments.
On the other hand, breaking bad news guidelines are designed based on Western cultures and their application in a non-Western country may decrease their effectiveness.To the best of our knowledge, there is no national guideline for breaking bad news in Iran. There is a long way to go before we can suggest a national guideline for emergency departments, so we recommend using one of the Western guidelines and indigenizing it according to the Iranian culture and emergency situations.
Mohammad Jalali, Ahmad Nasiri, Heidarali Abedi,
Volume 7, Issue 5 (1-2015)
Abstract
Breaking bad news to patients and their families is an important issue in health care services. Since access to information is among the basic rights of the patient, investigating the experiences of patients and their families after receiving bad news can make the process more purposeful and prevent unnecessary suffering. This study aimed to describe the experiences of patients and their families after hearing bad news from health providers.The present study was conducted with a qualitative, phenomenological approach. Participants were selected through purposive sampling from people who had the experience of receiving bad news during 2013 in Birjand, Iran. The sampling process continued up to the point of data saturation, which reduced the number of participants to 10. Note-taking was used to complete the data collection process. In this study Colaizzi's method was used for data analysis, while robustness of the study was assessed based on the criteria of precision.The subjects were between 25 and 70 years of age. First, according to Colaizzi's Method, 280 codes were obtained which were the same as the developed concepts. At this point, the code lists were extracted. Different thematic categories with similar meanings were placed in 5 thematically larger groups as follows: 1) tension at the beginning of the encounter, 2) adaptive responses, 3) spiritual relief, 4) family crises, and 5) seeking support.Patients and their families showed different reactions upon receiving bad news. The study showed that health providers can contribute to a better adjustment of patients and families and promote peace by acquiring a methodical approach while delivering bad news. This can be achieved by identifying the reactions, confusions and tensions, as well as introducing adaptive or supportive resources to patients and their families.
Bentolhoda Shirazi Sader , Siamak Afahin Majd , Shiva Rafati, Zahra Poshtchaman, Nahid Rejeh,
Volume 11, Issue 0 (3-2018)
Abstract
Considering the increasing prevalence of the malignant diseases and their great effects on the different aspects of the patients’ life and even their family, the disclosure of its diagnosis and trust telling to the patients have been changed to one of the main medical ethics challenges. This study aimed for the evaluation of patient’s tendency and their family to disclosure of malignant disease. This study was a cross-sectional research. It has been done with a questionnaire on the 270 people. The sample consisted of three groups: 100 patients without cancer disease, 100 patients’ family members, and 70 patients with cancer disease, who referred to Mustafa Khomeini Hospital. The data were analyzed through SPSS-16 software in this study, 74% of the patients with cancer and 85% of patients without cancer and 50% of patients’ families had tendency to know the diagnosis of malignant disease. In the case of prognosis, 39% of cancer patients and 75% of without cancer patients, were agreed to complete knowledge, and 42% of cancer patients and 22% of without cancer patients, agreed on relative knowledge. Regarding the result of this study and respecting the individuals' rights, it seems better for the patients with malignant disease to be informed of their diagnosis and prognosis by the health care workers. Furthermore, it would be better to implement strategies for improvement of patient-physician relationship through physicians' communication skills with patients.
Sooreh Khaki, Masoud Fallahi -Khoshknab, Farahnaz Mohammadi-Shahboulaghi, Gülbeyaz Can, Mohammad Ali Hosseini,
Volume 17, Issue 1 (3-2024)
Abstract
Conveying bad news to patients and their families is a process that requires team collaboration. Different countries have taken into consideration providing suitable solutions. This study aimed to develop an practical guideline, according to the experiences of patients, families, and healthcare providers in intensive care units across three phases. In the first phase, in-depth interviews were conducted with 31 participants selected through purposive sampling, and the initial draft of the practical guideline was created. In the second phase, the initial draft was discussed and reviewed by experts in two focus group meetings, and a secondary draft was developed. In the third phase, the practical guideline compiled by the Delphi method was validated by 43 experts in policymaking and decision-making. Finally, an practical guideline to deliver bad news to patients and their families was developed with 8 main steps and 43 sub-steps. The main steps included before delivering bad news (assessment, planning and preparation, coordination), during delivering bad news (announcing bad news, emotional support, summary and documentation), and after delivering bad news (referral, follow-up). This practical guideline is intended to facilitate the process of delivering bad news in intensive care units to achieve the desired outcomes and reduce the resulting consequences and harms. Accordingly, healthcare providers are recommended to consider the importance of patient and family preferences, adhering to scientific and standard methods for delivering bad news, and upholding the principles of professional ethics.
