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Search completed on: 16 October 2012

Search completed by: Richard Bridgen

Search details

Breaking bad news or advanced communication

Resources searched

NHS Evidence; TRIP Database; Cochrane Library; AMED; CINAHL; EMBASE; MEDLINE; PsychINFO; Google Scholar

Database search terms: (break* or broke) adj2 "bad news"; “advanced communication”; disclos* adj2 "bad news"; impart* adj2 "bad news"

Evidence search string(s): ((breaking OR imparting OR disclosing) "bad news") OR "advanced communication"

Google search string(s): ((breaking OR imparting OR disclosing) "bad news") OR ~"advanced communication"

Summary

There has been lots of research on breaking bad news and/or advanced communication published within the last three years.

Guidelines

American Academy of Pediatrics

Communicating with children and families: from everyday interactions to skill in conveying distressing information 2009

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British Association of Perinatal Medicine

Guidelines for the investigation of newborn infants who suffer a sudden and unexpected postnatal collapse in the first week of life 2011

from Standards for communicating with parents

Privacy in suitable surroundings where parents cannot be overheard or seen is important for all sensitive discussions with parents. This is especially important when breaking bad news.

Care Quality Commission

Essential standards of quality and safety 2010

Have somewhere private available for breaking bad news, where this is done.

Department of Health

Essence of Care 2010

procedures are in place for communicating people’s personal information in a confidential manner, for example, during handover procedures, consultant and/or teaching rounds, admission procedures and telephone calls, and when calling people in outpatients and breaking bad news

Healthcare for London

Dementia services guide

Good practice in breaking bad news of a diagnosis is sharing the information with the patient and carer at the speed of the individual’s understanding and willingness to listen.

NHS Newham have commissioned a diagnostic memory clinic, in which they have developed a multi-disciplinary formula for working with patients and carers that focuses on assessment findings, breaking bad news and follow-up care coordination and early intervention arrangements.

International Association for the Study of Pain

Guide to pain management in low-resource settings: chapter 8 - Principles of palliative care 2010

See p. 55 for SPIKES model.

NHS End of Life Care Programme

What do we know now that we didn’t know a year ago? New intelligence on end of life care in England 2012

16.11 Existing models for breaking bad news are inadequate for people with learning disabilities:

Breaking bad news to people with learning disabilities should be seen as a process, not a one-off event or series of events

Understanding of bad news is built gradually over time. Information needs to be broken down into singular chunks of knowledge that can be added over time to people’s existing knowledge base

Breaking bad news to people with learning disabilities should involve health and social care professionals as well as (family) carers and paid care staff

A new model for breaking bad news that has been developed for people with learning disabilities may also have relevance for other client groups.

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(Source: Tuffrey-Wijne, I. A new model for breaking bad news to people with intellectual disabilities, Palliative Medicine published online Jan 2012)

End of life care in heart failure: A framework for implementation 2010

ALL health professionals involved in communicating with patients or involved with the care of patients reaching the end of life should be trainedin advanced communication skills.

The route to success in end of life care: achieving quality for occupational therapy 2010

Use advanced communication skills such as active listening and open-ended questions to elicit the person’s ‘story’ and their key priorities

The route to success in end of life care: achieving quality in acute hospitals 2010

Train generalist and specialist staff to recognise a dying patient and in breaking bad news to relatives

Seek to provide private spaces in which to break bad news or to initiate end of life care discussions

Talking needs action training needs analysis: the pilot sites report their findings for end of life care communication skills 2010

Supporting people to live and die well: a framework for social care at the end of life 2010

NHS Evidence

Communication in cross-cultural cancer care 2012

NHS Kidney Care

Getting it right : End of life care in advanced kidney disease 2012

NICE

Raising sensitive issues with pregnant women: training plan for maternity settings 2011

Raising sensitive issues with pregnant women: tips

Healthcare professionals need to develop advanced communication skills to enable them to raise sensitive issues with women and to support them effectively. Detailed below are ten tips for raising sensitive issues with clients.

Renal Physicians Association

Shared decision-making in the appropriate initiation of and withdrawal from dialysis 2010

See box 7. A Six-Step Approach to Talking about Serious Illness.

Royal College of Nursing

Competences: an integrated career and competence framework for nurses working in the field of long-term follow-up and late effects care of children and young people after cancer 2011

Royal College of Radiologists

Good practice guide for clinical radiologists 2012

Clinical radiologists should receivie training in communication skills, including the process and timing of ‘breaking bad news.’

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Evidence-based reviews

Clinical Immediate Reference

Helping patients face death and dying 2011

Breaking Bad News 2010

Looking After People With Cancer 2009

Published research

From CINAHL

Managing the delivery of bad news: An in-depth analysis of doctors' delivery style. (includes abstract); Shaw J; Dunn S; Heinrich P; Patient Education & Counseling, 2012 May; 87 (2): 186-92 (journal article - research) ISSN: 0738-3991 PMID: 21917397 CINAHL AN: 2011541377

Abstract: OBJECTIVE: The purpose of this study was to identify and describe the delivery styles doctors typically use when breaking bad news (BBN). METHODS: Thirty one doctors were recruited to participate in two standardised BBN consultations involving a sudden death. Delivery styles were determined using time to deliver the bad news as a standardised differentiation as well as qualitative analysis of interaction content and language style. Communication performance was also assessed. RESULTS: Analysis of BBN interactions revealed three typical delivery styles. A blunt style characterised by doctors delivering news within the first 30s of the interaction; Forecasting, a staged delivery of the news within the first 2min and a stalling approach, delaying news delivery for more than 2min. This latter avoidant style relies on the news recipient reaching a conclusion about event outcome without the doctor explicitly conveying the news. CONCLUSION: Three typical bad news delivery styles used by doctors when BBN were confirmed both semantically and operationally in the study. The relationship between delivery style and the overall quality of BBN interactions was also investigated. PRACTICE IMPLICATIONS: This research provides a new template for approaching BBN training and provides evidence for a need for greater flexibility when communicating bad news.

Subjects: Physician-Patient Relations; Truth Disclosure; Adult: 19-44 years; Aged: 65+ years; Middle Aged: 45-64 years; Female; Male

Database: CINAHL with Full Text

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Response to "breaking bad news" (March 2012):... TU: Phan G Breaking bad news. ASCO Connect March, 2012. Ruckdeschel, John C; ASCO Connection, 2012 May; 3 (3): 7 (journal article - commentary, letter, pictorial) ISSN: 2155-2584 CINAHL AN: 2011543821

Subjects: Communication; Neoplasms; Physician-Patient Relations

Database: CINAHL with Full Text

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Communication skills training for oncology professionals. (includes abstract); Kissane DW; Bylund CL; Banerjee SC; Bialer PA; Levin TT; Maloney EK; D'Agostino TA; Journal of Clinical Oncology, 2012 Apr 10; 30 (11): 1242-7 (journal article - research) ISSN: 0732-183X PMID: 22412145 CINAHL AN: 2011516402

Abstract: PURPOSE To provide a state-of-the-art review of communication skills training (CST) that will guide the establishment of a universal curriculum for fellows of all cancer specialties undertaking training as oncology professionals today. METHODS Extensive literature review including meta-analyses of trials, conceptual models, techniques, and potential curricula provides evidence for the development of an appropriate curriculum and

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CST approach. Examples from the Memorial Sloan-Kettering Cancer Center CST program are incorporated. Results A core curriculum embraces CST modules in breaking bad news and discussing unanticipated adverse events, discussing prognosis, reaching a shared treatment decision, responding to difficult emotions, coping with survivorship, running a family meeting, and transitioning to palliative care and end of life. Achievable outcomes are growth in clinician's self-efficacy, uptake of new communication strategies and skills, and transfer of these strategies and skills into the clinic. Outcomes impacting patient satisfaction, improved adaptation, and enhanced quality of life are still lacking. CONCLUSION Future communication challenges include genetic risk communication, concepts like watchful waiting, cumulative radiation risk, late effects of treatment, discussing Internet information and unproven therapies, phase I trial enrollment, and working as a multidisciplinary team. Patient benefits, such as increased treatment adherence and enhanced adaptation, need to be demonstrated from CST.

Subjects: Communication; Oncology

Database: CINAHL with Full Text

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Breaking bad news. (includes abstract); Phan, Geao Q; ASCO Connection, 2012 Mar; 3 (2): 38-9 (journal article - pictorial) ISSN: 2155-2584 CINAHL AN: 2011473829

Abstract: Advice for conveying honest, thorough information in a compassionate, supportive manner.

Subjects: Empathy; Oncology; Physician-Patient Relations; Support, Psychosocial

Database: CINAHL with Full Text

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Interns' perspectives about communicating bad news to patients: a qualitative study. (includes abstract); Supe, A N; Education for Health: Change in Learning & Practice (Network: Towards Unity for Health), 2011 Dec; 24 (3): 541 (journal article - research) ISSN: 1357-6283 PMID: 22267350 CINAHL AN: 2011533156

Abstract: INTRODUCTION: Communicating bad news to patients and families is an essential skill for physicians but can be difficult for interns. Very little is known about skills in this area for interns in developing countries. METHOD: Two focus groups, consisting of a total of 12 interns, were conducted in the Seth G.S. Medical College and KEM Hospital in Mumbai, India. The grounded theory approach was used to identify common themes and concepts, which related to: (1) barriers in communicating bad news, (2) interns' confidence in communicating bad news, (3) interns' perceptions about their need for such training and (4) interns' suggested methods for training. RESULTS: Interns described barriers in time constraints, language, their personal fears, patients' illiteracy, crowded wards with no privacy and lack of training. All interns lacked confidence in breaking news of death, but seven were confident in breaking bad news about chronic diseases or cancers. Subjects reported they had received very little classroom teaching or formal instruction in this area, though they had had opportunities to observe a few instances of breaking bad news. They expressed need for increased focus on communication skills curriculum in the form of case discussions, workshops and small group teaching, in addition to clinical observation. CONCLUSIONS: Interns in our school in Mumbai reported inadequate training and low comfort and skill in communicating bad news and expressed need for focused training.

Subjects: Communication Skills Training; Interns and Residents; Physician-Patient Relations; Truth Disclosure

Database: CINAHL with Full Text

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Mandatory communication skills training for cancer and palliative care staff: Does one size fit all? (includes abstract); Turner, Mary; Payne, Sheila; O’Brien, Terri; European Journal of Oncology Nursing, 2011 Dec; 15 (5): 398-403 (journal article - research,

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tables/charts) ISSN: 1462-3889 PMID: 21163700 CINAHL AN: 2011352485

Abstract: Abstract: Purpose of the research: There is increasing recognition of the importance of good communication between healthcare professionals and patients facing cancer or end of life. In England, a new national 3-day training programme called ‘Connected’ has been developed and is now mandatory for all cancer and palliative care professionals. This study aimed to explore the attitudes of staff in one region to undertaking this training. Methods and sample: A survey questionnaire was developed through a series of discussions with experts and semi-structured interviews with five healthcare professionals. The questionnaire was distributed to 200 cancer and palliative care staff; 109 were completed and returned. Key results: There were significant differences between doctors’ and nurses’ attitudes to communication skills training, with doctors demonstrating more negative attitudes. More nurses than doctors felt that communication skills training should be mandatory for cancer and palliative care professionals (p ≤ 0.001), whilst more doctors felt that these staff should already be skilled communicators and not require further training (p ≤ 0.001). Nurses also self-rated their communication skills more highly than doctors. Conclusions: The current ‘one size fits all’ approach being taken nationally to advanced communication skills training does not meet the training preferences of all healthcare professionals, and it is recommended that tailoring courses to individuals’ needs should be considered.

Subjects: Communication Skills Training; Palliative Care; Professional-Patient Relations; Oncologic Care; Adult: 19-44 years; Middle Aged: 45-64 years; Male; Female

Database: CINAHL with Full Text

Developing and implementing an advanced communication training program in oncology at a comprehensive cancer center. (includes abstract); Bylund, Carma L; Brown, Richard F; Bialer, Philip A; Levin, Tomer T; Lubrano di Ciccone, Barbara; Kissane, David W; Journal of Cancer Education, 2011 Dec; 26 (4): 604-11 (journal article - research, tables/charts) ISSN: 0885-8195 PMID: 21541813 CINAHL AN: 2011372062

Abstract: Cancer patients report significant levels of unmet needs in the realm of communication. Communication skills training programs have been shown to improve clinical communication. However, advanced communication skills training programs in oncology have lacked institutional integration, and thus have not attended to institutional norms and cultures that may counteract explicit communication skills training. We developed and implemented an advanced communication skills training program made up of nine teaching modules for faculty, fellows, and residents. Training included didactic and experiential small group work. Self-efficacy and behavior change were assessed for individual participants. Since 2006, 515 clinicians have participated in this training program. Participants have shown significant gains in self-efficacy regarding communicating with patients in various contexts. Our initial work in this area demonstrates the implementation of such a program at a major cancer center to be feasible, to be acceptable, and to have a significant impact on participants' self-efficacy.

Subjects: Cancer Care Facilities; Communication Skills Training; Education, Continuing; Education, Interdisciplinary; Multidisciplinary Care Team; Oncologic Care

Database: CINAHL with Full Text

Factors influencing the attitudes and behaviors of oncologists regarding the truthful disclosure of information to patients with advanced and incurable cancer. (includes abstract); Cherny NI; Palliative Care Working Group of the European Society for Medical Oncology; Psycho-Oncology, 2011 Dec; 20 (12): 1269-84 (journal article - research) ISSN: 1057-9249 PMID: 20878723 CINAHL AN: 2011415151

Abstract: OBJECTIVE: To evaluate the attitudes of the European Oncologists to information disclosure to patients with advanced cancer, their self-reported behaviors, and the factors that influence both attitudes and behaviors. Methods: ESMO members were invited to complete an online questionnaire to evaluate both attitudes and clinical behaviors relating to the disclosure of information to patients with advanced cancer. Data were analyzed to evaluate demographic, educational and social factors influencing attitudes and behaviors. RESULTS: Two hundred and ninety-eight completed surveys were returned. The survey

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demonstrated strong internal consistency construct validity. The responses indicate that individual clinicians generally display a range of behaviors including non-disclosive as well as disclosive behaviors depending on the dynamics of individual interactions between oncologist and specific patient. Although regional cultural norms influence oncologists' attitudes toward disclosure and, indirectly, their self-reported behaviors, the impact is influenced by other factors: in particular, perceived institutional professional norms, the degree of training in breaking bad news and the frequency of exposure to requests by family members to withhold information from the patient. CONCLUSIONS: Positive attitudes regarding disclosure of information to patients and disclosive behaviors can be encouraged, even in non-Western countries, by the development of strong professional norms and education in breaking bad news and coping with the emotional responses of patients.

Subjects: Attitude of Health Personnel; Oncology; Neoplasms; Truth Disclosure

Database: CINAHL with Full Text

Breaking Bad News: The Patient's Viewpoint. (includes abstract); Munoz Sastre, Maria Teresa; Sorum, Paul Clay; Mullet, Etienne; Health Communication, 2011 Oct; 26 (7): 649-55 (journal article - research, tables/charts) ISSN: 1041-0236 PMID: 21598151 CINAHL AN: 2011313110

Abstract: The objective of this study was to ascertain how patients judge the acceptability of physicians' communication of bad news. Two hundred forty-five adults, who had in the past received bad medical news, indicated the acceptability of physicians' conduct in 48 vignettes of giving bad news to patients. Vignettes were all combinations of five factors: level of bad news (infection with hepatitis C, cirrhosis of the liver, or liver cancer); request or not to the patient to come with spouse or partner; attempt or not by the physician to find out the patient's expectations about the test results; presence or absence of emotional supportiveness; and provision or not of complete and understandable information. In addition, nine physicians rated the same vignettes. Quality of information and emotional supportiveness explained more than 95% of the variance in patients' acceptability judgments, while the degree of badness of the news had no impact. In addition, for patients, low emotional supportiveness could not be fully compensated by high quality of information, nor the inverse. Physicians, in contrast, responded as if such compensations were possible. Physicians must appreciate that patients expect high levels of both empathy and information quality, no matter how bad the news.

Subjects: Truth Disclosure; Patients; Physician-Patient Relations; Physicians; Adult: 19-44 years; Middle Aged: 45-64 years; Aged: 65+ years; Aged, 80 and over; Male; Female

Database: CINAHL with Full Text

Breaking bad news to patients: a guide for dental professionals. Porter, Kathy; Dental Nursing, 2011 Jul; 7 (7): 399-401 (journal article - pictorial) ISSN: 1749-6799 CINAHL AN: 2011235658

Subjects: Dental Care; Nurse-Patient Relations; Truth Disclosure

Database: CINAHL with Full Text

The communication competency of medical students, residents and consultants. (includes abstract); Wouda JC; van de Wiel HB; Patient Education & Counseling, 2012 Jan; 86 (1): 57-62 (journal article - research) ISSN: 0738-3991 PMID: 21501942 CINAHL AN: 2011409573

Abstract: OBJECTIVE: The model of expert performance predicts that neither physicians in training nor experienced physicians will reach an expert level in communication. This study tested this hypothesis. METHODS: Seventy-one students, twenty-five residents and fourteen consultants performed a 'breaking bad news' exercise with a simulated patient. Their communication competency was assessed with the CELI instrument. Actor assessments were also obtained. The differences in communication competency between students, residents and consultants were established. RESULTS: The mean performance scores ranged from bad to adequate. An expert level of performance was seldom reached. Novice students scored lower than the other groups in their competency and in the actor

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assessment. First-year students scored lower than the consultants in their competency and in the actor assessment. No differences in performance were found between third-year students, interns, residents and consultants. CONCLUSION: Students acquire a 'satisfactory' level of communication competency early in the curriculum. Communication courses in the curriculum do not enhance this level. Clinical experience has also a limited effect. PRACTICE IMPLICATIONS: The learning conditions for deliberate practice must be fulfilled in medical curricula and in postgraduate training in order to provide medical students and physicians the opportunity to attain an expert level in communication.

Subjects: Clinical Competence; Communication; Consultants; Internship and Residency; Physician-Patient Relations; Students, Medical; Truth Disclosure

Database: CINAHL with Full Text

Discussing Religion and Spirituality Is an Advanced Communication Skill: An Exploratory Structural Equation Model of Physician Trainee Self-Ratings. (includes abstract); Ford, Dee W.; Downey, Lois; Engelberg, Ruth; Back, Anthony L.; Curtis, J. Randall; Journal of Palliative Medicine, 2012 Jan; 15 (1): 63-70 (journal article - research, tables/charts) ISSN: 1096-6218 PMID: 22242716 CINAHL AN: 2011433052

Abstract: Background: Communication about religious and spiritual issues is fundamental to palliative care, yet little empirical data exist to guide curricula in this area. The goal of this study was to develop an improved understanding of physicians' perspectives on their communication competence about religious and spiritual issues. Methods: We examined surveys of physician trainees ( n=297) enrolled in an ongoing communication skills study at two medical centers in the northwestern and southeastern United States. Our primary outcome was self-assessed competence in discussing religion and spirituality. We used exploratory structural equation modeling (SEM) to develop measurement and full models for acquisition of self-assessed communication competencies. Results: Our measurement SEM identified two latent constructs that we label Basic and Intermediate Competence, composed of five self-assessed communication skills. The Basic Competence construct included overall satisfaction with palliative care skills and with discussing do not resuscitate (DNR) status. The Intermediate Competence construct included responding to inappropriate treatment requests, maintaining hope, and addressing fears about the end-of-life. Our full SEM model found that Basic Competence predicted Intermediate Competence and that Intermediate Competence predicted competence in religious and spiritual discussions. Years of clinical training directly influenced Basic Competence. Increased end-of-life discussions positively influenced Basic Competence and had a complex association with Intermediate Competence. Southeastern trainees perceived more competence in religious and spiritual discussions than northwestern trainees. Conclusion: This study suggests that discussion of religious and spiritual issues is a communication skill that trainees consider more advanced than other commonly taught communication skills, such as discussing DNR orders.

Subjects: Palliative Care; Spirituality; Physician-Patient Relations; Communication Skills

Database: CINAHL with Full Text

Teaching and evaluating breaking bad news: A pre-post evaluation study of a teaching intervention for medical students and a comparative analysis of different measurement instruments and raters. (includes abstract); Schildmann J; Kupfer S; Burchardi N; Vollmann J; Patient Education & Counseling, 2012 Feb; 86 (2): 210-9 (journal article - research) ISSN: 0738-3991 PMID: 21571487 CINAHL AN: 2011443582

Abstract: OBJECTIVE: To investigate changes of different domains of breaking bad news (bbn) competences after a teaching module for medical students, and to collage the results generated by different approaches of evaluation. METHODS: Rating of medical student-SP interactions by means of a global rating scale and a detailed checklist used by SPs and independent raters. RESULTS: Students improved their breaking bad news competency. However, the changes vary between the different domains of bbn competency. In addition, results generated by different evaluation instruments differ. CONCLUSION: This study serves as a stimulus for further research on the training of specific elements of bbn and different approaches of evaluating bbn competency. PRACTICE IMPLICATIONS: In light of the different facets of bbn competency, it is important to set priorities regarding the teaching

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aims and to provide a consistent approach.

Subjects: Clinical Competence; Education, Medical; Physician-Patient Relations; Students, Medical; Truth Disclosure; Adult: 19-44 years; Female; Male

Database: CINAHL with Full Text

Teaching Communication Skills Using Role-Play: An Experience-Based Guide for Educators. (includes abstract); Jackson, Vicki A.; Back, Anthony L.; Journal of Palliative Medicine, 2011 Jun; 14 (6): 775-80 (journal article - tables/charts) ISSN: 1096-6218 PMID: 21651366 CINAHL AN: 2011164100

Abstract: Teaching advanced communication skills requires educators who are not only excellent communicators themselves but have the ability to deconstruct the components of the interaction and develop a cognitive approach that can be used across a variety of learners, diverse content, and under different time constraints while helping the learner develop the skill of self-reflection in a 'safe' and effective learning environment. The use of role-play in small groups is an important method to help learners cultivate the skills required to engage in nuanced, often difficult conversations with seriously ill patients. To be effective, educators utilizing role-play must help learners set realistic goals and know when and how to provide feedback to the learners in a way that allows a deepening of skills and a promotion of self-awareness. The challenge is to do this in a manner that does not cause too much anxiety for the learner. In this article we outline an approach to teaching communication skills to advanced learners through the use of different types of role-play, feedback, and debriefing.

Subjects: Professional Practice, Evidence-Based; Role Playing; Practice Guidelines; Communication Skills Training

Database: CINAHL with Full Text

Conversations in end-of-life care: communication tools for critical care practitioners. (includes abstract); Shannon, Sarah E.; Long-Sutehall, Tracy; Coombs, Maureen; Nursing in Critical Care, 2011 May-Jun; 16 (3): 124-30 (journal article - tables/charts) ISSN: 1362-1017 PMID: 21481114 CINAHL AN: 2011003788

Abstract: Communication skills are the key for quality end-of-life care including in the critical care setting. While learning general, transferable communication skills, such as therapeutic listening, has been common in nursing education, learning specific communication tools, such as breaking bad news, has been the norm for medical education. Critical care nurses may also benefit from learning communication tools that are more specific to end-of-life care. We conducted a 90-min interactive workshop at a national conference for a group of 78 experienced critical care nurses where we presented three communication tools using short didactics. We utilized theatre style and paired role play simulation. The Ask-Tell-Ask, Tell Me More and Situation-Background-Assessment-Recommendation (SBAR) tools were demonstrated or practiced using a case of a family member who feels that treatment is being withdrawn prematurely for the patient. The audience actively participated in debriefing the role play to maximize learning. The final communication tool, SBAR, was practiced using an approach of pairing with another member of the audience. At the end of the session, a brief evaluation was completed by 59 nurses (80%) of the audience. These communication tools offer nurses new strategies for approaching potentially difficult and emotionally charged conversations. A case example illustrated strategies for applying these skills to clinical situations. The three tools assist critical care nurses to move beyond compassionate listening to knowing what to say. Ask-Tell-Ask reminds nurses to carefully assess concerns before imparting information. Tell Me More provides a tool for encouraging dialogue in challenging situations. Finally, SBAR can assist nurses to distill complex and often long conversations into concise and informative reports for colleagues.

Subjects: Communication Skills Training; Terminal Care; Critical Care Nursing

Database: CINAHL with Full Text

Hospital consultants breaking bad news with simulated patients: An analysis of communication using the Roter Interaction Analysis System. (includes abstract); Vail L;

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Sandhu H; Fisher J; Cooke H; Dale J; Barnett M; Patient Education & Counseling, 2011 May; 83 (2): 185-94 (journal article - research) ISSN: 0738-3991 PMID: 21459254 CINAHL AN: 2010998897

Abstract: OBJECTIVE: To explore how experienced clinicians from wide ranging specialities deliver bad news, and to investigate the relationship between physician characteristics and patient centredness. METHODS: Consultations involving 46 hospital consultants from 22 different specialties were coded using the Roter Interaction Analysis System. RESULTS: Consultants mainly focussed upon providing biomedical information and did not discuss lifestyle and psychosocial issues frequently. Doctor gender, age, place of qualification, and speciality were not significantly related to patient centredness. CONCLUSION: Hospital consultants from wide ranging specialities tend to adopt a disease-centred approach when delivering bad news. Consultant characteristics had little impact upon patient centredness. Further large-scale studies are needed to examine the effect of doctor characteristics on behaviour during breaking bad news consultations. PRACTICE IMPLICATIONS: It is possible to observe breaking bad news encounters by video-recording interactions between clinicians and simulated patients. Future training programmes should focus on increasing patient-centred behaviours which include actively involving patients in the consultation, initiating psychosocial discussion, and providing patients with opportunities to ask questions.

Subjects: Communication; Consultants; Patient Simulation; Physician-Patient Relations; Physicians; Truth Disclosure; Adult: 19-44 years; Female; Male

Database: CINAHL with Full Text

Breaking bad news: Communication skills for difficult conversations. (includes abstract); Davenport, Lisa; Schopp, Georgeanne; JAAPA: Journal of the American Academy of Physician Assistants, 2011 Feb; 24 (2): 46-50 (journal article - pictorial) ISSN: 1547-1896 PMID: 21387970 CINAHL AN: 2010954353

Abstract: PAs can develop the basic skills needed to deliver bad news and can learn how to promote consensus and understanding among patients, families, and the health care team.

Subjects: Communication Skills; Physician Assistants; Professional-Patient Relations

Database: CINAHL with Full Text

Patient preferences for the delivery of bad news - the experience of a UK Cancer Centre. (includes abstract); BROWN V; PARKER P; FURBER L; THOMAS A; European Journal of Cancer Care, 2011 Jan; 20 (1): 56-61 (journal article - research, tables/charts) ISSN: 0961-5423 PMID: 20148936 CINAHL AN: 2010885076 Abstract: The primary aim of this study was to assess how patients would prefer to be given their cancer diagnosis in a typical UK cancer centre. Two hundred and forty-four patients attending the oncology outpatient department at the Leicester Royal Infirmary, UK, were recruited. Patients were invited to complete the Measure of Patients' Preferences questionnaire, write comments on their own experience of the breaking bad news consultation and choose their preferred role in decision making. Over 90% of questionnaires were completed. Patients rated the items addressing the message content of the consultation as more important than the facilitative or the supportive aspects. Over 80% of patients wrote a detailed account of their experiences, of which 60% were satisfied with the consultation. Most of the patients who were dissatisfied commented on the unsympathetic or pessimistic manner of the doctor. The majority of patients wanted a collaborative role in decision making. Regarding the cancer diagnosis, the majority of patients have information needs, want to be involved in treatment decisions and know their prognosis. The difficulty for physicians is how to meet individual information needs, give hope, but not deliver unrealistic expectations.

Subjects: Neoplasms; Diagnosis; Communication; Aged: 65+ years; Male; Female

Database: CINAHL with Full Text

Communicating with cancer patients: what areas do physician assistants find most challenging? (includes abstract); Parker, Patricia A.; Ross, Alicia C.; Polansky, Maura N.; Palmer, J. Lynn; Rodriguez, M. Alma; Baile, Walter F.; Journal of Cancer Education, 2010

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Dec; 25 (4): 524-9 (journal article - questionnaire/scale, research, tables/charts) ISSN: 0885-8195 PMID: 20383673 CINAHL AN: 2010875894

Abstract: Physician assistants (PAs) and other midlevel practitioners have been taking on increasing clinical roles in oncology settings. Little is known about the communication needs and skills of oncology PAs. PAs working in oncology (n=301) completed an online survey that included questions about their perceived skill and difficulty on several key communication tasks. Overall, PAs rated these communication tasks as "somewhat" to "moderately" difficult and their skill level in these areas as "average" to "good." Areas of most perceived difficulty were intervening with angry patients or those in denial and breaking bad news. Highest perceived skills were in communicating with patients from cultures and religions different than your own and telling patient he/she has cancer or disease has progressed, and the lowest perceived skills were in discussing do not resuscitate orders. There are areas in which enhancement of communication skills may be needed, and educational opportunities should be developed for PAs working in oncology.

Subjects: Cancer Patients; Communication Skills; Oncologic Care; Physician Assistants; Professional Practice; Professional-Patient Relations; Adult: 19-44 years; Middle Aged: 45-64 years; Female; Male

Database: CINAHL with Full Text

Strategies for breaking bad news to patients with cancer. Becze E; ONS Connect, 2010 Sep; 25 (9): 14-5 (journal article - pictorial, protocol, teaching materials) ISSN: 1935-1623 PMID: 20945670 CINAHL AN: 2010826345

Subjects: Communication; Nurse-Patient Relations; Cancer Patients

Database: CINAHL with Full Text

SPIKES: a framework for breaking bad news to patients with cancer. (includes abstract); Kaplan M; Kaplan M; Clinical Journal of Oncology Nursing, 2010 Aug; 14 (4): 514-6 (journal article - case study) ISSN: 1092-1095 PMID: 20682509 CINAHL AN: 2010740518

Abstract: SPIKES is an acronym for presenting distressing information in an organized manner to patients and families. The SPIKES protocol provides a step-wise framework for difficult discussions such as when cancer recurs or when palliative or hospice care is indicated. Each letter represents a phase in the six-step sequence. S stands for setting, P for perception, I for invitation or information, K for knowledge, E for empathy, and S for summarize or strategize. Breaking bad news is a complex communication task, but following the SPIKES protocol can help ease the distress felt by the patient who is receiving the news and the healthcare professional who is breaking the news. Key components of the SPIKES strategy include demonstrating empathy, acknowledging and validating the patient's feelings, exploring the patient's understanding and acceptance of the bad news, and providing information about possible interventions. Having a plan of action provides structure for this difficult discussion and helps support all involved.

Subjects: Cancer Patients; Professional-Patient Relations; Truth Disclosure; Aged: 65+ years; Female

Database: CINAHL with Full Text

Disclosure and understanding of cancer diagnosis and prognosis for people with intellectual disabilities: findings from an ethnographic study. (includes abstract); Tuffrey-Wijne I; Bernal J; Hollins S; European Journal of Oncology Nursing, 2010 Jul; 14 (3): 224-30 (journal article - case study, research, tables/charts) ISSN: 1462-3889 PMID: 20181525 CINAHL AN: 2010697135

Abstract: PURPOSE: Growing numbers of people with intellectual disabilities are diagnosed with a life-limiting illness such as cancer. Little is known about disclosure of diagnosis and prognosis to this group. The study aim was to explore how much people with intellectual disabilities who have cancer understand about their diagnosis and prognosis, and to explore how much they are told about their cancer. METHOD: 13 people with intellectual disabilities and cancer took part in a 3-year ethnographic study. Data collection consisted mostly of

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participant observation. Participants were visited regularly for a median of 7 months. RESULTS: Eleven participants were told that they had cancer, but most were not helped to understand the implications of this diagnosis or their prognosis. Decisions around disclosure, as well as the task of truth-telling, rested mostly with relatives and paid carers. Those with severe/profound intellectual disabilities were most likely to be protected from the truth. Understanding was affected by cognitive ability, life experience and truth-telling. Lack of understanding affected the ability to take decisions about treatment and care. CONCLUSIONS: Existing models for breaking bad news are inadequate for people with intellectual disabilities. The findings suggest that more open communication is needed, but further studies are needed to establish best practice in this area.

Subjects: Mental Retardation; Neoplasms; Neoplasms; Truth Disclosure; Adult: 19-44 years; Middle Aged: 45-64 years; Female; Male

Database: CINAHL with Full Text

Breaking bad news in inpatient clinical settings: role of the nurse. (includes abstract); Warnock C; Tod A; Foster J; Soreny C; Journal of Advanced Nursing, 2010 Jul; 66 (7): 1543-55 (journal article - research, tables/charts) ISSN: 0309-2402 PMID: 20492016 CINAHL AN: 2010682941

Abstract: Aim. This paper is a report of an exploration of the role of the nurse in the process of breaking bad news in the inpatient clinical setting and the provision of education and support for nurses carrying out this role. Background. The term 'breaking bad news' is mostly associated with the moment when negative medical information is shared with a patient or relative. However, it can also be seen as a process of interactions that take place before, during and after bad news is broken. Little research has been conducted exploring the role of the nurse in the process of breaking bad news in the inpatient clinical setting. Methods. A questionnaire was developed using Likert scales and open text questions. Data collection took place in 2007. Fifty-nine inpatient areas took part in the study; 335 questionnaires were distributed in total and 236 were completed (response rate 70%). Results. Nurses engaged in diverse breaking bad news activities at many points in care pathways. Relationships with patients and relatives and uncontrolled and unplanned events shaped the context in which they provided this care. Little formal education or support for this work had been received. Conclusion. Guidance for breaking bad news should encompass the whole process of doing this and acknowledge the challenges nurses face in the inpatient clinical area. Developments in education and support are required that reflect the challenges that nurses encounter in the inpatient care setting.

Subjects: Inpatients; Nurse-Patient Relations; Nursing Role; Nursing Staff, Hospital; Truth Disclosure; Adult: 19-44 years; Middle Aged: 45-64 years

Database: CINAHL with Full Text

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Breaking bad news: schizophrenia. (includes abstract); Seeman MV; Journal of Psychiatric Practice, 2010 Jul; 16 (4): 269-76 (journal article - protocol) ISSN: 1527-4160 PMID: 20644364 CINAHL AN: 2010737496

Abstract: The aim of this paper is to help physicians deliver the diagnosis of schizophrenia by adopting and adapting the popular oncology protocol, SPIKES. Data sources for the paper are PubMed searches (1984-2009), entering the phrase "breaking bad news." Of the 269 articles retrieved, those with face relevance to schizophrenia were selected and references contained in them were further searched. The conclusion of the paper is that, as in oncology, revealing a serious psychiatric diagnosis is emotionally difficult for both physician and patient; guidelines help, but individualization is essential.

Subjects: Physician-Patient Relations; Schizophrenia; Truth Disclosure

Database: CINAHL with Full Text

13

'BREAKS' Protocol for Breaking Bad News. Narayanan V; Bista B; Koshy C; Indian Journal of Palliative Care, 2010 May-Aug; 16 (2): 61-65 (journal article) ISSN: 0973-1075 PMID: 21811349 CINAHL AN: 2011164614

Subjects: Communication; Disease; Physician-Patient Relations; Protocols; Terminally Ill Patients

Database: CINAHL with Full Text

Beyond bad news: communication skills of nurses in palliative care. (includes abstract); Malloy P; Virani R; Kelly K; Munévar C; Journal of Hospice & Palliative Nursing, 2010 May-Jun; 12 (3): 166-76 (journal article - CEU, exam questions, research, tables/charts) ISSN: 1522-2179 CINAHL AN: 2010668426

Abstract: Communication skills are paramount in effective delivery of palliative care. The emphasis in much of the previous literature has been on physician communication and also has been largely focused on the singular topic of breaking bad news. Much less emphasis has been placed on communication as a vital skill of nurses and on the opportunities for nurses, as they are often the key professionals at the bedside after "bad news" is shared. The study was conducted as a survey of nurses (N = 333) attending an End-of-Life Nursing Education Consortium conference. The survey assessed nurses' perspectives of the most challenging aspects of communication in their work and elicited examples of both positive and negative communication. Results of the survey indicate important areas for future research and education to enhance nurses' abilities to communicate effectively and compassionately. Respondents identified several key areas in need of improvement related to communication. Examples of the most difficult areas of communication include discussing bad news, talking with physicians about palliative care issues, discussing spiritual concerns, and talking with patients/families from different cultures. Nurses are the primary, constant healthcare providers across clinical settings, and effective skills in communication are critical to nursing practice and to ensure quality care. Education regarding communication skills is needed in basic and graduate nursing education programs as well as in continuing education for practicing nurses.

Subjects: Communication Skills; Hospice and Palliative Nursing

Database: CINAHL with Full Text

Improving residents' end-of-life communication skills with a short retreat: a randomized controlled trial. (includes abstract); Szmuilowicz E; el-Jawahri A; Chiappetta L; Kamdar M; Block S; Journal of Palliative Medicine, 2010 Apr; 13 (4): 439-52 (journal article - randomized controlled trial, research, tables/charts) ISSN: 1096-6218 PMID: 20201666 CINAHL AN: 2010628290

Abstract: Background: Internal medicine residents are largely unprepared to carry out end-of-life (EOL) conversations. There is evidence that these skills can be taught, but data from randomized controlled trials are lacking. Purpose: We studied whether a day-long communication skills training retreat would lead to enhanced performance of and confidence with specific EOL conversations. We also studied the effect of the retreat on residents' ability to respond to patient emotions. Methods: PGY-2 resident volunteers were randomly assigned to a retreat group or a control group. The retreat involved a combination of teaching styles and skills practice with standardized patients. All participants completed questionnaires and were evaluated carrying out two types of conversations (breaking bad news or discussing direction of care) with a standardized patient before (T1) and after (T2) the intervention phase. Conversations were audio-taped and later rated by a researcher blinded to group assignment and time of assessment. Results: Forty-nine residents agreed to randomization (88%) with 23 residents randomized to the retreat group and 26 to the control group. Compared to controls, retreat participants demonstrated higher T2 scores for breaking bad news, discussing direction of care, and responding to emotion. Comparing T2 to T1, the retreat group's improvement in responding to emotion was statistically significant. The retreat group's confidence improved significantly only for the breaking bad news construct. Conclusions: A short course for residents can significantly improve specific elements of resident EOL conversation performance, including the ability to respond to

14

emotional cues.

Subjects: Communication; Emotions; Physician-Patient Relations; Terminally Ill Patients

Database: CINAHL with Full Text

Breaking bad news to patients: this valuable communication skill will reward you in the end. (includes abstract); Caillier R; Podiatry Management, 2010 Jan; 29 (1): 123-4 (journal article) ISSN: 0744-3528 CINAHL AN: 2010538549

Abstract: This valuable communication skill will reward you in the end.

Subjects: Professional-Patient Relations; Truth Disclosure

Database: CINAHL with Full Text

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From AMED, EMBASE, MEDLINE and PsychINFO

The communication competency of medical students, residents and consultants.

Wouda JC. van de Wiel HB.

Patient Education & Counseling. 86(1):57-62, 2012 Jan.

[Journal Article. Research Support, Non-U.S. Gov't]

UI: 21501942

OBJECTIVE: The model of expert performance predicts that neither physicians in training nor experienced physicians will reach an expert level in communication. This study tested this hypothesis.

METHODS: Seventy-one students, twenty-five residents and fourteen consultants performed a 'breaking bad news' exercise with a simulated patient. Their communication competency was assessed with the CELI instrument. Actor assessments were also obtained. The differences in communication competency between students, residents and consultants were established.

RESULTS: The mean performance scores ranged from bad to adequate. An expert level of performance was seldom reached. Novice students scored lower than the other groups in their competency and in the actor assessment. First-year students scored lower than the consultants in their competency and in the actor assessment. No differences in performance were found between third-year students, interns, residents and consultants.

CONCLUSION: Students acquire a 'satisfactory' level of communication competency early in the curriculum. Communication courses in the curriculum do not enhance this level. Clinical experience has also a limited effect.

PRACTICE IMPLICATIONS: The learning conditions for deliberate practice must be fulfilled in medical curricula and in postgraduate training in order to provide medical students and physicians the opportunity to attain an expert level in communication. Copyright Copyright 2011 Elsevier Ireland Ltd. All rights reserved.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Wouda, Jan C. van de Wiel, Harry B M.

Institution

Wenckebach Institute, University Medical Centre, Groningen, The Netherlands. j.c.wouda@psb.umcg.nl

15

Abbreviated Source

Patient Educ Couns. 86(1):57-62, 2012 Jan.

NLM Journal Name

Patient education and counseling

Publisher Identifier

Journal available in: Print-Electronic. Citation processed from: Internet

NLM Journal Code

pec, 8406280

Journal Subset

N

Country of Publication

Ireland

Emtree Heading

*Clinical Competence. *Communication. *Consultants/px [Psychology]. Cross-Sectional Studies. Curriculum. Educational Measurement. Educational Status. Humans. *Internship and Residency. Netherlands. Patient Education as Topic. *Physician-Patient Relations. Statistics as Topic. *Students, Medical/px [Psychology]. *Truth Disclosure.

ISSN Electronic

1873-5134

ISSN Linking

0738-3991

Language

English

Electronic Date of Publication

20110417

Date of Publication

2012 Jan

Date Created

20111219

Year of Publication

2012

Editors

20120425

Entry Week

20120426

Link to the Ovid Full Text or citation:

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Teaching communication skills using role-play: an experience-based guide for educators.

Jackson VA. Back AL.

Journal of Palliative Medicine. 14(6):775-80, 2011 Jun.

16

[Journal Article. Research Support, N.I.H., Extramural]

UI: 21651366

Teaching advanced communication skills requires educators who are not only excellent communicators themselves but have the ability to deconstruct the components of the interaction and develop a cognitive approach that can be used across a variety of learners, diverse content, and under different time constraints while helping the learner develop the skill of self-reflection in a 'safe' and effective learning environment. The use of role-play in small groups is an important method to help learners cultivate the skills required to engage in nuanced, often difficult conversations with seriously ill patients. To be effective, educators utilizing role-play must help learners set realistic goals and know when and how to provide feedback to the learners in a way that allows a deepening of skills and a promotion of self-awareness. The challenge is to do this in a manner that does not cause too much anxiety for the learner. In this article we outline an approach to teaching communication skills to advanced learners through the use of different types of role-play, feedback, and debriefing.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Jackson, Vicki A. Back, Anthony L.

Institution

Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. VJackson@partners.org

Comments

Comment in: J Palliat Med. 2011 Jun;14(6):774; PMID: 21651365

Abbreviated Source

J Palliat Med. 14(6):775-80, 2011 Jun.

NLM Journal Name

Journal of palliative medicine

Publisher Identifier

Journal available in: Print. Citation processed from: Internet

NLM Journal Code

d0c, 9808462

Other ID

Source: NLM. PMC3155105 [Available on 06/01/12]

Journal Subset

IM

Country of Publication

United States

Emtree Heading

*Communication. Feedback. Guidelines as Topic. Humans. Palliative Care. *Role Playing. Teaching/og [Organization & Administration].

ISSN Electronic

1557-7740

ISSN Linking

1557-7740

17

Grant Number

R25 119019 (United States PHS HHS)

Language

English

Date of Publication

2011 Jun

Date Created

20110609

Year of Publication

2011

Editors

20111108

Entry Week

20111214

Link to the Ovid Full Text or citation:

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Teaching breaking bad news using mixed reality simulation.

Bowyer MW. Hanson JL. Pimentel EA. Flanagan AK. Rawn LM. Rizzo AG. Ritter EM. Lopreiato JO.

Journal of Surgical Research. 159(1):462-7, 2010 Mar.

[Comparative Study. Journal Article]

UI: 19665731

BACKGROUND: Our novel teaching approach involved having students actively participate in an unsuccessful resuscitation of a high fidelity human patient simulator with a gun shot wound to the chest, followed immediately by breaking bad news (BBN) to a standardized patient wife (SPW) portrayed by an actress.

METHODS: Brief education interventions to include viewing a brief video on the SPIKES protocol on how to break bad news, a didactic lecture plus a demonstration, or both, was compared to no pretraining by dividing 553 students into four groups prior to their BBN to the SPW. The students then self-assessed their abilities, and were also evaluated by the SPW on 21 items related to appearance, communication skills, and emotional affect. All received cross-over training.

RESULTS: Groups were equal in prior training (2 h) and belief that this was an important skill to be learned. Students rated the experience highly, and demonstrated marked improvement of self-assessed skills over baseline, which was maintained for the duration of the 12-wk clerkship. Additionally, students who received any of the above training prior to BBN were rated superior to those who had no training on several communication skills, and the observation of the video seemed to offer the most efficient way of teaching this skill in a time delimited curriculum.

CONCLUSION: This novel approach was well received and resulted in improvement over baseline. Lessons learned from this study have enhanced our curricular approach to this vital component of medical education. Published by Elsevier Inc.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

18

MEDLINE

Authors Full Name

Bowyer, Mark W. Hanson, Janice L. Pimentel, Elisabeth A. Flanagan, Amy K. Rawn, Lisa M. Rizzo, Anne G. Ritter, E Matthew. Lopreiato, Joseph O.

Institution

National Capital Area Medical Simulation Center of the Uniformed Services University of the Health Sciences, Department of Surgery, Bethesda, Maryland 20814, USA. mbowyer@usuhs.mil

Abbreviated Source

J Surg Res. 159(1):462-7, 2010 Mar.

NLM Journal Name

The Journal of surgical research

Publisher Identifier

Journal available in: Print-Electronic. Citation processed from: Internet

NLM Journal Code

k7b, 0376340

Journal Subset

IM

Country of Publication

United States

Emtree Heading

*Education, Medical/mt [Methods]. Humans. Patient Simulation. Role Playing. Students, Medical/px [Psychology]. *Truth Disclosure.

ISSN Electronic

1095-8673

ISSN Linking

0022-4804

Language

English

Electronic Date of Publication

20090520

Date of Publication

2010 Mar

Date Created

20100223

Year of Publication

2010

Editors

20100323

Entry Week

20111214

Link to the Ovid Full Text or citation:

19

Click here for full text options

Successful use of web-based learning instruction for a complex communication skill.

Ganje T., Dooley-Hash S.L., Hopson L.

Academic Emergency Medicine. Conference: 2012 Annual Meeting of the Society for Academic Emergency Medicine, SAEM 2012 Chicago, IL United States. Conference Start: 20120509 Conference End: 20120512. Conference Publication: (var.pagings). 19 (pp S376), 2012. Date of Publication: April 2012.

[Journal: Conference Abstract]

AN: 70745876

Background: Notification of a patient's death to family members represents a challenging and stressful task for emergency physicians. Complex communication skills such as those required for breaking bad news (BBN) are conventionally taught with small-group and other interactive learning formats. We developed a de novo multi-media web-based learning (WBL) module of curriculum content for a standardized patient interaction (SPI) for senior medical students during their emergency medicine rotation. Objectives: We proposed that use of an asynchronous WBL module would result in students' skill acquisition for breaking bad news. Methods: We tracked module utilization and performance on the SPI to determine whether students accessed the materials and if they were able to demonstrate proficiency in its application. Performance on the SPI was assessed utilizing a BBN-specific content instrument developed from the GRIEV-ING mnemonic as well as a previously validated instrument for assessing communication skills. Results: Three hundred seventy-two students were enrolled in the BBN curriculum. There was a 92% completion rate of the WBL module despite students being given the option to utilize review articles alone for preparation. Students interacted with the activities within the module as evidenced by a meannumber of mouse clicks of 42.1 (SD 21.6). Overall SPI scores were 94.5%, (SD 4.4) with content checklist scores of 92.8% (SD 5.7) and interpersonal communication scores 97.9% (SD 4.7). Five students had failing content scores (<75%) on the SPI and had a mean number of clicks of 30.8 (SD 28.2), which is not significantly lower than those passing (p = 0.21). Students in the first year of WBL deployment completed self-confidence assessments which showed significant increases in confidence (2.86 to 3.44, p < 0.001 on a five-point scale) after completion of the WBLactivity (n = 125, 91.9% response rate). Conclusion: A high rate of completion of the WBL module despite presence of alternative is suggestive of student acceptance of this method for instruction in communication skills. Students utilizing the multi-media WBL module can successfully complete a SPI for a complex communication skill indicating that asynchronous, on-line techniques can be used to augment instruction.

Institution

(Ganje, Dooley-Hash, Hopson) University of Michigan, Ann Arbor, MI, United States

Correspondence Address

T. Ganje, University of Michigan, Ann Arbor, MI, United States

Publisher

Blackwell Publishing Ltd

Emtree Heading

*communication skill; *society; *emergency medicine; *learning; human; student; click; curriculum; patient; skill; emergency physician; medical student; interpersonal communication; checklist; mouse; death.

ISSN

1069-6563

DOI

http://dx.doi.org/10.1111/j.1553-2712.2012.01332.x

Language

English

20

Summary Language

English

Entry Week

201222

Date Delivered

20120520

Year of Publication

2012

Copyright

Copyright 2012 Elsevier B.V., All rights reserved.

Link to the Ovid Full Text or citation:

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Strategies for breaking bad news to patients with cancer.

Becze E.

ONS Connect. 25(9):14-5, 2010 Sep.

[Journal Article]

UI: 20945670

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Becze, Elisa.

Abbreviated Source

ONS Connect. 25(9):14-5, 2010 Sep.

NLM Journal Name

ONS connect

Publisher Identifier

Journal available in: Print. Citation processed from: Print

NLM Journal Code

101300056

Journal Subset

N

Country of Publication

United States

Emtree Heading

Abbreviations as Topic. Empathy. Humans. Neoplasms/di [Diagnosis]. Neoplasms/px [Psychology]. *Neoplasms. *Nurse's Role. Nurse-Patient Relations. *Oncologic Nursing/mt [Methods]. Social Support. *Truth Disclosure.

ISSN

21

1935-1623

ISSN Linking

1935-1623

Language

English

Date of Publication

2010 Sep

Date Created

20101015

Year of Publication

2010

Editors

20101130

Entry Week

20111214

Link to the Ovid Full Text or citation:

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SPIKES: a framework for breaking bad news to patients with cancer.

Kaplan M.

Clinical journal of oncology nursing. 14 (4) (pp 514-516), 2010. Date of Publication: Aug 2010.

[Journal: Article]

AN: 20682509

SPIKES is an acronym for presenting distressing information in an organized manner to patients and families. The SPIKES protocol provides a step-wise framework for difficult discussions such as when cancer recurs or when palliative or hospice care is indicated. Each letter represents a phase in the six-step sequence. S stands for setting, P for perception, I for invitation or information, K for knowledge, E for empathy, and S for summarize or strategize. Breaking bad news is a complex communication task, but following the SPIKES protocol can help ease the distress felt by the patient who is receiving the news and the healthcare professional who is breaking the news. Key components of the SPIKES strategy include demonstrating empathy, acknowledging and validating the patient's feelings, exploring the patient's understanding and acceptance of the bad news, and providing information about possible interventions. Having a plan of action provides structure for this difficult discussion and helps support all involved.

Institution

(Kaplan) Weill Cornell Medical Center, New York Presbyterian Hospital, New York, New York, USA. marcellekaplan @gmail.com

Correspondence Address

M. Kaplan, Weill Cornell Medical Center, New York Presbyterian Hospital, New York, New York, USA. marcellekaplan @gmail.com

Country of Publication

United States

Emtree Heading

aged; article; breast tumor; clinical protocol; female; human; human relation; *interpersonal

22

communication; *neoplasm; *nurse patient relationship; nursing.

Electronic ISSN

1538-067X

Language

English

Entry Week

201000

Date Delivered

20110304

Year of Publication

2010

Copyright

MEDLINE is the source for the citation and abstract of this record.

Link to the Ovid Full Text or citation:

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Physician-patient communication: breaking bad news.

Fields S.A., Johnson W.M.

The West Virginia medical journal. 108 (2) (pp 32-35), 2012. Date of Publication: 2012 Mar-Apr.

[Journal: Article]

AN: 22655433

Physicians often struggle with how to manage the task of breaking bad news with patients. Moreover, the arduous nature of the task can contribute to physician detachment from the patient or an avoidance of breaking the news in a timely manner. A plan of action can only improve physician confidence in breaking bad news, and also make the task more manageable. Over a decade ago, Rabow and McPhee offered a strategy; the ABCDE plan, which provided a patient centered framework from which to deliver troubling news to patients and families. At the heart of this plan was the creation of a safe environment, the demonstration of timely communication skills, and the display of empathy on the physician's part. Careful consideration of the doctor's own reactions to death and dying also played an important role. A close review of the five tenets of this plan indicates the relevance of Rabow and McPhee's strategy today. The patient base in our nation and state continues to be older, on average, and physicians are faced with numerous patients who have terminal illness. A constructive plan with specific ideas for breaking bad news can help physicians effectively navigate this difficult task.

Institution

(Fields) WVU School of Medicine, Department of Family Medicine, Charleston Division, USA.

Correspondence Address

S.A. Fields, WVU School of Medicine, Department of Family Medicine, Charleston Division, USA.

Country of Publication

United States

Emtree Heading

article; *doctor patient relation; empathy; human; *interpersonal communication; patient

23

satisfaction; physician attitude.

ISSN

0043-3284

Language

English

Entry Week

201228

Date Delivered

20120705

Year of Publication

2012

Copyright

MEDLINE is the source for the citation and abstract of this record.

Link to the Ovid Full Text or citation:

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Pediatric oncologists opinions on breaking bad news.

Johnston D.L., Appleby W.

Pediatric Blood and Cancer. 56 (3) (pp 506-506), 2011. Date of Publication: March 2011.

[Journal: Letter]

AN: 2011021960

Institution

(Johnston, Appleby) Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada

Correspondence Address

D.L. Johnston, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. E-mail: djohnston@cheo.on.ca

Country of Publication

United States

Publisher

Wiley-Liss Inc. (111 River Street, Hoboken NJ 07030-5774, United States)

Emtree Heading

empathy; family; human; letter; medical education; *medical practice; *pediatrician; priority journal; prognosis; social worker.

Number of References

1

Embase Section Headings

Pediatrics and Pediatric Surgery [7], Cancer [16], Public Health, Social Medicine and Epidemiology [17]

ISSN

1545-5009

Electronic ISSN

24

1545-5017

DOI

http://dx.doi.org/10.1002/pbc.22896

CODEN

PBCEA

Language

English

Entry Week

201100

Date Delivered

20110126

Year of Publication

2011

Copyright

Copyright 2011 Elsevier B.V., All rights reserved.

Link to the Ovid Full Text or citation:

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Patient preferences for the delivery of bad news - the experience of a UK Cancer Centre.

Brown V.A., Parker P.A., Furber L., Thomas A.L.

European Journal of Cancer Care. 20 (1) (pp 56-61), 2011. Date of Publication: January 2011.

[Journal: Article]

AN: 20148936

The primary aim of this study was to assess how patients would prefer to be given their cancer diagnosis in a typical UK cancer centre. Two hundred and forty-four patients attending the oncology outpatient department at the Leicester Royal Infirmary, UK, were recruited. Patients were invited to complete the Measure of Patients' Preferences questionnaire, write comments on their own experience of the breaking bad news consultation and choose their preferred role in decision making. Over 90% of questionnaires were completed. Patients rated the items addressing the message content of the consultation as more important than the facilitative or the supportive aspects. Over 80% of patients wrote a detailed account of their experiences, of which 60% were satisfied with the consultation. Most of the patients who were dissatisfied commented on the unsympathetic or pessimistic manner of the doctor. The majority of patients wanted a collaborative role in decision making. Regarding the cancer diagnosis, the majority of patients have information needs, want to be involved in treatment decisions and know their prognosis. The difficulty for physicians is how to meet individual information needs, give hope, but not deliver unrealistic expectations. 2010 Blackwell Publishing Ltd.

Institution

(Brown, Furber, Thomas) Departement of Oncology, Leicester Royal Infirmary, Leicester, United Kingdom (Parker) Departement of Behavioural Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States

Correspondence Address

A.L. Thomas, Department of Cancer Studies and Molecular Medicine, Leicester Royal Infirmary, Leicester, LE1 5WW, United Kingdom. E-mail: at107@le.ac.uk

25

Country of Publication

United Kingdom

Publisher

Blackwell Publishing Ltd

Keyword

Cancer, Information needs, Oncology, Patient preferences, Patient-physician communication

Emtree Heading

adult; aged; article; *attitude to health; cancer center; decision making; doctor patient relation; female; human; *interpersonal communication; male; middle aged; *neoplasm/di [Diagnosis]; *patient preference; psychological aspect; questionnaire; United Kingdom.

Number of References

20

ISSN

0961-5423

Electronic ISSN

1365-2354

DOI

http://dx.doi.org/10.1111/j.1365-2354.2009.01156.x

Language

English

Summary Language

English

Entry Week

201000

Date Delivered

20110530

Year of Publication

2011

Copyright

MEDLINE is the source for the citation and abstract of this record.

Link to the Ovid Full Text or citation:

Click here for full text options

Medical students' perspectives on clinical empathy training.

Afghani B., Besimanto S., Amin A., Shapiro J.

Education for health (Abingdon, England). 24 (1) (pp 544), 2011. Date of Publication: Apr 2011.

[Journal: Article]

AN: 21710425

There is a need for studies specifically addressing the barriers to empathy training from the perspective of medical students. The objective of this study was to evaluate attitudes of 3rd and 4th year medical students regarding their training in clinical empathy at a public teaching hospital and medical school. A questionnaire assessing students' satisfaction with, and

26

opinions on, empathy training, as well as barriers to training, was distributed during the last quarter of the year. Of 188 eligible participants, 157 (84%) responded. Approximately one-half of the respondents said empathy could be taught. Eighty-one percent of respondents felt that their empathy had increased or stayed the same during their training. When asked about barriers for learning empathy, the majority of respondents chose time pressure and lack of good role models. Respondents rated breaking bad news, talking to patients about medical mistakes and taking care of dying or demanding patients as areas in need of more empathy-related training. Although the majority of students were satisfied with their training of clinical empathy, our study highlights the need for innovative methods to address concerns regarding barriers to practicing empathy, as well as the need for more training in how to demonstrate empathy in challenging clinical situations.

Institution

(Afghani) UCI-CHOC PSF Hospitalist.

Correspondence Address

B. Afghani, UCI-CHOC PSF Hospitalist.

Country of Publication

United Kingdom

Emtree Heading

article; *attitude; clinical competence; doctor patient relation; *empathy; female; human; interview; male; medical education; *medical student; psychological aspect; questionnaire; *teaching; United States.

Electronic ISSN

1469-5804

Language

English

Entry Week

201100

Date Delivered

20111103

Year of Publication

2011

Copyright

MEDLINE is the source for the citation and abstract of this record.

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Mandatory communication skills training for cancer and palliative care staff: does one size fit all?.

Turner M. Payne S. O'Brien T.

European Journal of Oncology Nursing. 15(5):398-403, 2011 Dec.

[Journal Article. Research Support, Non-U.S. Gov't]

UI: 21163700

PURPOSE OF THE RESEARCH: There is increasing recognition of the importance of good communication between healthcare professionals and patients facing cancer or end of life. In England, a new national 3-day training programme called 'Connected' has been developed and is now mandatory for all cancer and palliative care professionals. This study

27

aimed to explore the attitudes of staff in one region to undertaking this training.

METHODS AND SAMPLE: A survey questionnaire was developed through a series of discussions with experts and semi-structured interviews with five healthcare professionals. The questionnaire was distributed to 200 cancer and palliative care staff; 109 were completed and returned.

KEY RESULTS: There were significant differences between doctors' and nurses' attitudes to communication skills training, with doctors demonstrating more negative attitudes. More nurses than doctors felt that communication skills training should be mandatory for cancer and palliative care professionals (p <= 0.001), whilst more doctors felt that these staff should already be skilled communicators and not require further training (p <= 0.001). Nurses also self-rated their communication skills more highly than doctors.

CONCLUSIONS: The current 'one size fits all' approach being taken nationally to advanced communication skills training does not meet the training preferences of all healthcare professionals, and it is recommended that tailoring courses to individuals' needs should be considered. Copyright ACopyright 2010 Elsevier Ltd. All rights reserved.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Turner, Mary. Payne, Sheila. O'Brien, Terri.

Institution

School of Health and Medicine, Lancaster University, Lancaster LA1 4YT, UK. j.m.turner@lancaster.ac.uk

Abbreviated Source

EUR J ONCOL NURS. 15(5):398-403, 2011 Dec.

NLM Journal Name

European journal of oncology nursing : the official journal of European Oncology Nursing Society

Publisher Identifier

Journal available in: Print-Electronic. Citation processed from: Internet

NLM Journal Code

100885136

Journal Subset

IM, N

Country of Publication

Scotland

Emtree Heading

Adult. *Attitude of Health Personnel. Clinical Competence. Communication. England. Female. Humans. Male. *Mandatory Programs. *Medical Staff/ed [Education]. Medical Staff/px [Psychology]. Middle Aged. Neoplasms/nu [Nursing]. *Neoplasms/th [Therapy]. *Nursing Staff/ed [Education]. Nursing Staff/px [Psychology]. *Palliative Care. Professional-Patient Relations.

ISSN Electronic

1532-2122

ISSN Linking

1462-3889

28

Language

English

Electronic Date of Publication

20101215

Date of Publication

2011 Dec

Date Created

20111104

Year of Publication

2011

Editors

20120308

Entry Week

20120309

Link to the Ovid Full Text or citation:

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Learning how to break bad news--more than following the rules.

Spencer J.

Medical teacher. 34 (5) (pp 349-350), 2012. Date of Publication: 2012.

[Journal: Note]

AN: 22471915

Institution

(Spencer) School of Medical Sciences Education Development, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.

Correspondence Address

J. Spencer, School of Medical Sciences Education Development, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.

Country of Publication

United Kingdom

Emtree Heading

*clinical education; *doctor patient relation; human; *interpersonal communication; *medical education; *medical student; note; psychological aspect.

Electronic ISSN

1466-187X

DOI

http://dx.doi.org/10.3109/0142159X.2012.672778

Language

English

Entry Week

201235

29

Date Delivered

20120823

Year of Publication

2012

Copyright

MEDLINE is the source for the citation and abstract of this record.

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Learning clinical communication skills: outcomes of a program for professional practitioners.

Carvalho IP. Pais VG. Almeida SS. Ribeiro-Silva R. Figueiredo-Braga M. Teles A. Castro-Vale I. Mota-Cardoso R.

Patient Education & Counseling. 84(1):84-9, 2011 Jul.

[Evaluation Studies. Journal Article]

UI: 20542402

OBJECTIVE: To assess the effects of a communication skills program on professional practitioners' performance and self-confidence in clinical interviewing.

METHODS: Twenty-five health professionals took 3 months of basic communication skills followed by 3 months of advanced communication skills. An additional quarter dealt with self-awareness and communication in special situations. Participants' performances were evaluated in clinical interviews with standardized patients before, during and after the program by external observers and standardized patients, using standardized instruments. Participants assessed their own confidence in their communication skills before and after the program. Data were analysed using GLM repeated-measures procedures in SPSS.

RESULTS: Basic communication skills and self-confidence improved throughout the 6 months; competencies declined but self-confidence continued to increase 4 months later. Compared with taking no course, differences were statistically significant after the 6 months (external observers only) and 4 months later (external observers and participants).

CONCLUSION: The program effectively improved communication skills, although significantly only when assessed by external observers. Four months later, effects were significant in communication skills (external observers), despite the decline and in self-confidence.

PRACTICE IMPLICATIONS: While periodical enrollment in programs for the practice of communication skills may help maintain performance, more knowledge on communication and self-awareness may enhance self-confidence. Copyright Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Carvalho, Irene P. Pais, Vanessa G. Almeida, Susana S. Ribeiro-Silva, Raquel. Figueiredo-Braga, Margarida. Teles, Ana. Castro-Vale, Ivone. Mota-Cardoso, Rui.

Institution

Department of Medical Psychology at the School of Medicine, University of Porto, Porto, Portugal. irenec@med.up.pt

30

Abbreviated Source

Patient Educ Couns. 84(1):84-9, 2011 Jul.

NLM Journal Name

Patient education and counseling

Publisher Identifier

Journal available in: Print-Electronic. Citation processed from: Internet

NLM Journal Code

pec, 8406280

Journal Subset

N

Country of Publication

Ireland

Emtree Heading

*Clinical Competence. *Communication. Educational Measurement. *Health Personnel/ed [Education]. Humans. *Interviews as Topic. Learning. Patient Simulation. Professional-Patient Relations. Program Evaluation. *Self Efficacy.

ISSN Electronic

1873-5134

ISSN Linking

0738-3991

Language

English

Electronic Date of Publication

20100612

Date of Publication

2011 Jul

Date Created

20110613

Year of Publication

2011

Editors

20111013

Entry Week

20111214

Link to the Ovid Full Text or citation:

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Is the clinical nurse specialist ideally situated as the patients key worker to break bad news.

Logan J., Hurwitz V., Bhangoo R., Ashkan K., Brazil L., Beaney R.

Neuro-Oncology. Conference: 10th Congress of European Association Of NeuroOncology Marseille France. Conference Start: 20120906 Conference End: 20120909. Conference

31

Publication: (var.pagings). 14 (pp iii83), 2012. Date of Publication: September 2012.

[Journal: Conference Abstract]

AN: 70889601

The breaking of significant news is a complex issue. As a result of a patient satisfaction survey carried out to be compliant with NICE Improving Outcomes Guidance (IOG) for people with brain and other CNS tumours, patients and their careers identified that although satisfied with the service, many felt that 'breaking bad news' or giving of histology could be improved. The clinical nurse specialist team looked at ways of improving this service to patients and their carers. As a result they implemented a nurse led results clinic, which runs on a weekly basis. meaning that all patients are seen within the time frame outlined in the IOG. Dedicated time was set aside in a Macmillan funded information centre, in an environment away from the main hospital site. DISCUSSION/METHODS: Patient's who have attended the clinic have been sent a questionnaire to assess the clinics success. It poses the question; 'Is the clinical nurse specialist ideally situated as the patients key worker to break bad news' results of a prospective questionnaire based study. RESULTS: 15 questionnaires have been sent out with a response rate of 46%. Of the returned questionnaires, 85% (6/7) felt that the clinical nurse specialist was ideally suited to deliver results, the other 15%(1/7) would have preferred a consultant in charge of their care. When asked if enough information was given regarding further treatment 57% (4/7) stated all treatment options were fully explained with a further 28%stating they received as much information as they wanted. In terms of location, 42% (3/7) felt that the information centre was exactly the right environment for the clinic and a further 28% (2/7) were happy with location. 15%(1/7) felt that theMacmillan branding and information in the centre made them feel uncomfortable, however they remained satisfied with the consultation. Following a 30 minute consultation, patients are given literature to take away with them, including aMacmillan information booklet, information prescription and contact details for their key worker this happened with 85% (6/7) of patients who completed the questionnaire. Conclusion. This small sample of patients are satisfied with their nurse led results clinic, and feel that the Macmillan information centre is an ideally situated location. The questionnaires continue to be sent out to gain further quantitative data to strength and expand the conclusions made in this study.

Institution

(Logan, Hurwitz, Bhangoo, Ashkan, Brazil, Beaney) Kings College Hospital, London, United Kingdom

Correspondence Address

J. Logan, Kings College Hospital, London, United Kingdom

Publisher

Oxford University Press

Emtree Heading

*human; *worker; *patient; *clinical nurse specialist; hospital; questionnaire; consultation; nurse; environment; histology; brain; patient satisfaction; prescription; central nervous system.

ISSN

1522-8517

DOI

http://dx.doi.org/10.1093/neuonc/nos183

Language

English

Summary Language

English

Entry Week

201241

32

Date Delivered

20121006

Year of Publication

2012

Copyright

Copyright 2012 Elsevier B.V., All rights reserved.

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Is it possible to improve residents breaking bad news skills? A randomised study assessing the efficacy of a communication skills training program.

Lienard A. Merckaert I. Libert Y. Bragard I. Delvaux N. Etienne AM. Marchal S. Meunier J. Reynaert C. Slachmuylder JL. Razavi D.

British Journal of Cancer. 103(2):171-7, 2010 Jul 13.

[Journal Article. Randomized Controlled Trial. Research Support, Non-U.S. Gov't]

UI: 20628395

BACKGROUND: This study aims to assess the efficacy of a 40-h training programme designed to teach residents the communication skills needed to break the bad news.

METHODS: Residents were randomly assigned to the training programme or to a waiting list. A simulated patient breaking bad news (BBN) consultation was audiotaped at baseline and after training in the training group and 8 months after baseline in the waiting-list group. Transcripts were analysed by tagging the used communication skills with a content analysis software (LaComm) and by tagging the phases of bad news delivery: pre-delivery, delivery and post-delivery. Training effects were tested with generalised estimating equation (GEE) and multivariate analysis of variance (MANOVA).

RESULTS: The trained residents (n=50) used effective communication skills more often than the untrained residents (n=48): more open questions (relative rate (RR)=5.79; P<0.001), open directive questions (RR=1.71; P=0.003) and empathy (RR=4.50; P=0.017) and less information transmission (RR=0.72; P=0.001). The pre-delivery phase was longer for the trained (1 min 53 s at baseline and 3 min 55 s after training) compared with the untrained residents (2 min 7 s at baseline and 1 min 46 s at second assessment time; P<0.001).

CONCLUSION: This study shows the efficacy of training programme designed to improve residents' BBN skills. The way residents break bad news may thus be improved.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Lienard, A. Merckaert, I. Libert, Y. Bragard, I. Delvaux, N. Etienne, A-M. Marchal, S. Meunier, J. Reynaert, C. Slachmuylder, J-L. Razavi, D.

Institution

Clinique de Psycho-Oncologie et des Soins Supportifs, Institut Jules Bordet, Brussels, Belgium.

Abbreviated Source

Br J Cancer. 103(2):171-7, 2010 Jul 13.

NLM Journal Name

33

British journal of cancer

Publisher Identifier

Journal available in: Print. Citation processed from: Internet

NLM Journal Code

av4, 0370635

Other ID

Source: NLM. PMC2906741

Journal Subset

IM

Country of Publication

England

Emtree Heading

*Communication. *Education. Humans. *Internship and Residency. *Physician-Patient Relations. *Truth Disclosure.

ISSN Electronic

1532-1827

ISSN Linking

0007-0920

Language

English

Date of Publication

2010 Jul 13

Date Created

20100714

Year of Publication

2010

Editors

20100805

Revised Date

20110801

Entry Week

20111214

Link to the Ovid Full Text or citation:

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Interns' perspectives about communicating bad news to patients: a qualitative study.

Supe AN.

Education for Health. 24(3):541, 2011 Dec.

[Journal Article]

UI: 22267350

INTRODUCTION: Communicating bad news to patients and families is an essential skill for

34

physicians but can be difficult for interns. Very little is known about skills in this area for interns in developing countries.

METHOD: Two focus groups, consisting of a total of 12 interns, were conducted in the Seth G.S. Medical College and KEM Hospital in Mumbai, India. The grounded theory approach was used to identify common themes and concepts, which related to: (1) barriers in communicating bad news, (2) interns' confidence in communicating bad news, (3) interns' perceptions about their need for such training and (4) interns' suggested methods for training.

RESULTS: Interns described barriers in time constraints, language, their personal fears, patients' illiteracy, crowded wards with no privacy and lack of training. All interns lacked confidence in breaking news of death, but seven were confident in breaking bad news about chronic diseases or cancers. Subjects reported they had received very little classroom teaching or formal instruction in this area, though they had had opportunities to observe a few instances of breaking bad news. They expressed need for increased focus on communication skills curriculum in the form of case discussions, workshops and small group teaching, in addition to clinical observation.

CONCLUSIONS: Interns in our school in Mumbai reported inadequate training and low comfort and skill in communicating bad news and expressed need for focused training.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Supe, A N.

Institution

KEM Hospital, Parel, Mumbai, Maharashtra, India. avisupe@gmail.com

Abbreviated Source

EDUC HEALTH. 24(3):541, 2011 Dec.

NLM Journal Name

Education for health (Abingdon, England)

Publisher Identifier

Journal available in: Print-Electronic. Citation processed from: Internet

NLM Journal Code

9607101

Journal Subset

IM

Country of Publication

England

Emtree Heading

*Communication. *Communication Barriers. Curriculum. Data Collection. *Education, Medical, Graduate/mt [Methods]. Focus Groups. Humans. India. *Internship and Residency. Learning. Patient Care/px [Psychology]. Physician-Patient Relations. Qualitative Research. Tape Recording. *Teaching/mt [Methods]. *Truth Disclosure.

ISSN Electronic

1469-5804

ISSN Linking

1357-6283

35

Language

English

Electronic Date of Publication

20111212

Date of Publication

2011 Dec

Date Created

20120123

Year of Publication

2011

Editors

20120529

Entry Week

20120530

Link to the Ovid Full Text or citation:

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Informing cancer patient in relation to his type of personality: the dependent (oral) patient.

Kallergis G.

Journal of B.U.On.. 16(2):366-71, 2011 Apr-Jun.

[Journal Article]

UI: 21766513

When a doctor has to break bad news to the cancer patient, he knows that the news will put a strain on his relationship with the patient. Bad news is any information that changes a person's view of the future in a negative way. The questions: "Do you tell the diagnosis or not? How much information do you reveal? Who do you inform about the diagnosis and/or what do you tell" are very frequent during scientific discussions. Must the patients know or do they also have the right not to know? Is it possible to determine who should be told what, when and how? The aim of this paper was to describe the dependent character or type of personality, so that a therapist can make a diagnosis in order to determine the informative approach.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Kallergis, G.

Institution

Department of Mental Health and Behavioral Sciences, School of Health, University of Athens, Athens, Greece. gkallerg@nurs.uoa.gr

Abbreviated Source

J. Balk. Union Oncol.. 16(2):366-71, 2011 Apr-Jun.

NLM Journal Name

36

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

Publisher Identifier

Journal available in: Print. Citation processed from: Print

NLM Journal Code

100883428

Journal Subset

IM

Country of Publication

Greece

Emtree Heading

*Communication. Humans. *Neoplasms/di [Diagnosis]. *Neoplasms/px [Psychology]. *Personality. Physician-Patient Relations. *Truth Disclosure.

ISSN

1107-0625

ISSN Linking

1107-0625

Language

English

Date of Publication

2011 Apr-Jun

Date Created

20110718

Year of Publication

2011

Editors

20110913

Entry Week

20111214

Link to the Ovid Full Text or citation:

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Improving residents' end-of-life communication skills with a short retreat: a randomized controlled trial.

Szmuilowicz E. el-Jawahri A. Chiappetta L. Kamdar M. Block S.

Journal of Palliative Medicine. 13(4):439-52, 2010 Apr.

[Journal Article. Randomized Controlled Trial. Research Support, Non-U.S. Gov't]

UI: 20201666

BACKGROUND: Internal medicine residents are largely unprepared to carry out end-of-life (EOL) conversations. There is evidence that these skills can be taught, but data from randomized controlled trials are lacking.

PURPOSE: We studied whether a day-long communication skills training retreat would lead to enhanced performance of and confidence with specific EOL conversations. We also

37

studied the effect of the retreat on residents' ability to respond to patient emotions.

METHODS: PGY-2 resident volunteers were randomly assigned to a retreat group or a control group. The retreat involved a combination of teaching styles and skills practice with standardized patients. All participants completed questionnaires and were evaluated carrying out two types of conversations (breaking bad news or discussing direction of care) with a standardized patient before (T1) and after (T2) the intervention phase. Conversations were audio-taped and later rated by a researcher blinded to group assignment and time of assessment.

RESULTS: Forty-nine residents agreed to randomization (88%) with 23 residents randomized to the retreat group and 26 to the control group. Compared to controls, retreat participants demonstrated higher T2 scores for breaking bad news, discussing direction of care, and responding to emotion. Comparing T2 to T1, the retreat group's improvement in responding to emotion was statistically significant. The retreat group's confidence improved significantly only for the breaking bad news construct.

CONCLUSIONS: A short course for residents can significantly improve specific elements of resident EOL conversation performance, including the ability to respond to emotional cues.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Szmuilowicz, Eytan. el-Jawahri, Areej. Chiappetta, Laurel. Kamdar, Mihir. Block, Susan.

Institution

Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. eszmuilo@nmh.org

Abbreviated Source

J Palliat Med. 13(4):439-52, 2010 Apr.

NLM Journal Name

Journal of palliative medicine

Publisher Identifier

Journal available in: Print. Citation processed from: Internet

NLM Journal Code

d0c, 9808462

Journal Subset

IM

Country of Publication

United States

Emtree Heading

Adult. Analysis of Variance. Clinical Competence/st [Standards]. Clinical Competence/sn [Statistics & Numerical Data]. Communication. Curriculum. Education. Educational Measurement/st [Standards]. Educational Measurement/sn [Statistics & Numerical Data]. Educational Status. Female. Humans. Illinois. Internal Medicine/ed [Education]. *Internal Medicine/st [Standards]. Internal Medicine/sn [Statistics & Numerical Data]. *Internship and Residency/st [Standards]. Internship and Residency/sn [Statistics & Numerical Data]. Male. Massachusetts. *Palliative Care/st [Standards]. *Physician-Patient Relations. Psychometrics. Questionnaires. *Terminal Care/st [Standards]. *Truth Disclosure. United States.

ISSN Electronic

1557-7740

38

ISSN Linking

1557-7740

Language

English

Date of Publication

2010 Apr

Date Created

20100413

Year of Publication

2010

Editors

20110113

Entry Week

20111214

Link to the Ovid Full Text or citation:

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Hospital consultants breaking bad news with simulated patients: An analysis of communication using the Roter Interaction Analysis System.

Vail L., Sandhu H., Fisher J., Cooke H., Dale J., Barnett M.

Patient Education and Counseling. 83 (2) (pp 185-194), 2011. Date of Publication: May 2011.

[Journal: Article]

AN: 2011178231

Objective: To explore how experienced clinicians from wide ranging specialities deliver bad news, and to investigate the relationship between physician characteristics and patient centredness. Methods: Consultations involving 46 hospital consultants from 22 different specialties were coded using the Roter Interaction Analysis System. Results: Consultants mainly focussed upon providing biomedical information and did not discuss lifestyle and psychosocial issues frequently. Doctor gender, age, place of qualification, and speciality were not significantly related to patient centredness. Conclusion: Hospital consultants from wide ranging specialities tend to adopt a disease-centred approach when delivering bad news. Consultant characteristics had little impact upon patient centredness. Further large-scale studies are needed to examine the effect of doctor characteristics on behaviour during breaking bad news consultations. Practice implications: It is possible to observe breaking bad news encounters by video-recording interactions between clinicians and simulated patients. Future training programmes should focus on increasing patient-centred behaviours which include actively involving patients in the consultation, initiating psychosocial discussion, and providing patients with opportunities to ask questions. 2010 Elsevier Ireland Ltd.

Institution

(Vail) Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, United Kingdom (Sandhu, Fisher, Cooke, Dale, Barnett) Warwick Medical School, University of Warwick, United Kingdom

Correspondence Address

L. Vail, Health Sciences Research Institute, Warwick Medical School, University of Warwick, Gibbett Hill Road, Coventry, CV4 7AL, United Kingdom. E-mail: Laura.vail@warwick.ac.uk

39

Country of Publication

Ireland

Publisher

Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)

Keyword

Breaking bad news, Doctor-patient communication, Patient centredness, Roter Interaction Analysis System

Emtree Heading

adult; age; article; computer analysis; consultation; doctor patient relation; female; human; *interpersonal communication; lifestyle; male; medical specialist; patient education; *physician attitude; priority journal; process model; Roter interaction analysis system; sex difference; social interaction; social psychology; videorecording.

Number of References

51

Embase Section Headings

Public Health, Social Medicine and Epidemiology [17], Biophysics, Bioengineering and Medical Instrumentation [27]

ISSN

0738-3991

DOI

http://dx.doi.org/10.1016/j.pec.2010.05.016

CODEN

PEDCD

Language

English

Summary Language

English

Entry Week

201100

Date Delivered

20110413

Year of Publication

2011

Copyright

Copyright 2011 Elsevier B.V., All rights reserved.

Link to the Ovid Full Text or citation:

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Hearing Bad News.

Morse J.

Journal of Medical Humanities. 32 (3) (pp 187-211), 2011. Date of Publication: September 2011.

40

[Journal: Article]

AN: 21503780

Personal reports of receiving bad news provide data that describes patients' comprehension, reflections, experienced emotions, and an interpretative commentary with the wisdom of hindsight. Analysis of autobiographical accounts of "hearing bad news" enables the identification of patterns of how patients found out diagnoses, buffering techniques used, and styles of receiving the news. I describe how patients grapple with the news, their somatic responses to hearing, and how they struggle and strive to accept what they are hearing. I discuss metaphors used within the languages of hearing bad news. Finally, I discuss implications for a change of focus in the breaking bad news research agenda, that is, from the physician's "performance" to a patient-focused agenda. 2011 Springer Science+Business Media, LLC.

Institution

(Morse) 2151 E. 900 S, Salt Lake City, UT 84108, United States

Correspondence Address

J. Morse, 2151 E. 900 S, Salt Lake City, UT 84108, United States. E-mail: Janice.Morse@nurs.utah.edu

Country of Publication

United States

Publisher

Springer New York (233 Springer Street, New York NY 10013-1578, United States)

Keyword

Biographical description, Breaking bad news, Emotion, Hearing bad news

Emtree Heading

*adaptive behavior; article; comprehension; *doctor patient relation; *emotion; human; *interpersonal communication; *literature; psychological aspect; *terminal disease.

Number of References

45

ISSN

1041-3545

Electronic ISSN

1573-3645

DOI

http://dx.doi.org/10.1007/s10912-011-9138-4

Language

English

Summary Language

English

Entry Week

201202

Date Delivered

20120110

Year of Publication

2011

Copyright

41

MEDLINE is the source for the citation and abstract of this record.

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Factors influencing the attitudes and behaviors of oncologists regarding the truthful disclosure of information to patients with advanced and incurable cancer.

Cherny NI. Palliative Care Working Group of the European Society for Medical Oncology.

Psycho-Oncology. 20(12):1269-84, 2011 Dec.

[Journal Article. Research Support, Non-U.S. Gov't]

UI: 20878723

OBJECTIVE: To evaluate the attitudes of the European Oncologists to information disclosure to patients with advanced cancer, their self-reported behaviors, and the factors that influence both attitudes and behaviors. Methods: ESMO members were invited to complete an online questionnaire to evaluate both attitudes and clinical behaviors relating to the disclosure of information to patients with advanced cancer. Data were analyzed to evaluate demographic, educational and social factors influencing attitudes and behaviors.

RESULTS: Two hundred and ninety-eight completed surveys were returned. The survey demonstrated strong internal consistency construct validity. The responses indicate that individual clinicians generally display a range of behaviors including non-disclosive as well as disclosive behaviors depending on the dynamics of individual interactions between oncologist and specific patient. Although regional cultural norms influence oncologists' attitudes toward disclosure and, indirectly, their self-reported behaviors, the impact is influenced by other factors: in particular, perceived institutional professional norms, the degree of training in breaking bad news and the frequency of exposure to requests by family members to withhold information from the patient.

CONCLUSIONS: Positive attitudes regarding disclosure of information to patients and disclosive behaviors can be encouraged, even in non-Western countries, by the development of strong professional norms and education in breaking bad news and coping with the emotional responses of patients. Copyright Copyright 2010 John Wiley & Sons, Ltd.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Cherny, Nathan I. Palliative Care Working Group of the European Society for Medical Oncology.

Institution

Shaare Zedek Medical Center, Department of Oncology, Cancer Pain and Palliative Medicine Service, Jerusalem, Israel. chernyn@netvision.net.il

Entry Week

Cherny NI. Catane R. Chasen MR. Grigorescu AC. Kloke M. Olver I. Ozyilkan O. Pohl GM. Ripamonti C. Rubach M. Rukhadze T. Schrijvers D. Stevens AM. Strasser F. Wagnerova M.

Abbreviated Source

Psychooncology. 20(12):1269-84, 2011 Dec.

NLM Journal Name

Psycho-oncology

Publisher Identifier

42

Journal available in: Print-Electronic. Citation processed from: Internet

NLM Journal Code

cps, 9214524

Journal Subset

IM

Country of Publication

England

Emtree Heading

*Attitude of Health Personnel. Humans. Medical Oncology/ed [Education]. *Medical Oncology. *Neoplasms/px [Psychology]. Physician-Patient Relations. Questionnaires. *Truth Disclosure.

ISSN Electronic

1099-1611

ISSN Linking

1057-9249

DOI

http://dx.doi.org/10.1002/pon.1853

Language

English

Electronic Date of Publication

20100928

Date of Publication

2011 Dec

Date Created

20111121

Year of Publication

2011

Editors

20120326

Entry Week

20120327

Link to the Ovid Full Text or citation:

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Discussing religion and spirituality is an advanced communication skill: An exploratory structural equation model of physician trainee self-ratings.

Ford D.W., Downey L., Engelberg R., Back A.L., Curtis J.R.

Journal of Palliative Medicine. 15 (1) (pp 63-70), 2012. Date of Publication: 01 Jan 2012.

[Journal: Review]

AN: 2012057715

Background: Communication about religious and spiritual issues is fundamental to palliative care, yet little empirical data exist to guide curricula in this area. The goal of this study was

43

to develop an improved understanding of physicians' perspectives on their communication competence about religious and spiritual issues. Methods: We examined surveys of physician trainees (n=297) enrolled in an ongoing communication skills study at two medical centers in the northwestern and southeastern United States. Our primary outcome was self-assessed competence in discussing religion and spirituality. We used exploratory structural equation modeling (SEM) to develop measurement and full models for acquisition of self-assessed communication competencies. Results: Our measurement SEM identified two latent constructs that we label Basic and Intermediate Competence, composed of five self-assessed communication skills. The Basic Competence construct included overall satisfaction with palliative care skills and with discussing do not resuscitate (DNR) status. The Intermediate Competence construct included responding to inappropriate treatment requests, maintaining hope, and addressing fears about the end-of-life. Our full SEM model found that Basic Competence predicted Intermediate Competence and that Intermediate Competence predicted competence in religious and spiritual discussions. Years of clinical training directly influenced Basic Competence. Increased end-of-life discussions positively influenced Basic Competence and had a complex association with Intermediate Competence. Southeastern trainees perceived more competence in religious and spiritual discussions than northwestern trainees. Conclusion: This study suggests that discussion of religious and spiritual issues is a communication skill that trainees consider more advanced than other commonly taught communication skills, such as discussing DNR orders. 2012, Mary Ann Liebert, Inc.

Institution

(Ford) Medical University of South Carolina, Division of Pulmonary and Critical Care, Department of Medicine, 96 Jonathan Lucas Drive, Charleston, SC 29425, United States (Downey, Engelberg, Curtis) Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle, WA, United States

(Back) Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA, United States

Correspondence Address

D.W. Ford, Medical University of South Carolina, Division of Pulmonary and Critical Care, Department of Medicine, 96 Jonathan Lucas Drive, Charleston, SC 29425, United States. E-mail: fordd@musc.edu

Country of Publication

United States

Publisher

Mary Ann Liebert Inc. (140 Huguenot Street, New Rochelle NY 10801-5215, United States)

Emtree Heading

adult; *communication skill; do not resuscitate; female; human; male; *medical student; normal human; palliative therapy; patient assessment; *religion; resuscitation; review; *self concept; terminal care; United States; university hospital.

Number of References

39

Embase Section Headings

Public Health, Social Medicine and Epidemiology [17]

ISSN

1096-6218

Electronic ISSN

1557-7740

DOI

http://dx.doi.org/10.1089/jpm.2011.0168

CODEN

44

JPAMF

Language

English

Summary Language

English

Entry Week

201206

Date Delivered

20120202

Year of Publication

2012

Copyright

Copyright 2012 Elsevier B.V., All rights reserved.

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Disclosure and understanding of cancer diagnosis and prognosis for people with intellectual disabilities: findings from an ethnographic study.

Tuffrey-Wijne I. Bernal J. Hollins S.

European Journal of Oncology Nursing. 14(3):224-30, 2010 Jul.

[Case Reports. Journal Article. Research Support, Non-U.S. Gov't]

UI: 20181525

PURPOSE: Growing numbers of people with intellectual disabilities are diagnosed with a life-limiting illness such as cancer. Little is known about disclosure of diagnosis and prognosis to this group. The study aim was to explore how much people with intellectual disabilities who have cancer understand about their diagnosis and prognosis, and to explore how much they are told about their cancer.

METHOD: 13 people with intellectual disabilities and cancer took part in a 3-year ethnographic study. Data collection consisted mostly of participant observation. Participants were visited regularly for a median of 7 months.

RESULTS: Eleven participants were told that they had cancer, but most were not helped to understand the implications of this diagnosis or their prognosis. Decisions around disclosure, as well as the task of truth-telling, rested mostly with relatives and paid carers. Those with severe/profound intellectual disabilities were most likely to be protected from the truth. Understanding was affected by cognitive ability, life experience and truth-telling. Lack of understanding affected the ability to take decisions about treatment and care.

CONCLUSIONS: Existing models for breaking bad news are inadequate for people with intellectual disabilities. The findings suggest that more open communication is needed, but further studies are needed to establish best practice in this area.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Tuffrey-Wijne, Irene. Bernal, Jane. Hollins, Sheila.

45

Institution

St George's, University of London, Division of Mental Health, Cranmer Terrace, London SW17 0RE, UK. ituffrey@sgul.ac.uk <ituffrey@sgul.ac.uk>

Abbreviated Source

EUR J ONCOL NURS. 14(3):224-30, 2010 Jul.

NLM Journal Name

European journal of oncology nursing : the official journal of European Oncology Nursing Society

Publisher Identifier

Journal available in: Print-Electronic. Citation processed from: Internet

NLM Journal Code

100885136

Journal Subset

IM, N

Country of Publication

Scotland

Emtree Heading

Adult. Aged. Anthropology, Cultural. *Attitude to Health. Communication. Decision Making. Family/px [Psychology]. Female. Humans. Informed Consent/px [Psychology]. Intellectual Disability/co [Complications]. *Intellectual Disability/px [Psychology]. Male. Middle Aged. Models, Psychological. Neoplasms/co [Complications]. *Neoplasms/di [Diagnosis]. *Neoplasms/px [Psychology]. Nursing Methodology Research. Prognosis. Qualitative Research. *Truth Disclosure.

ISSN Electronic

1532-2122

ISSN Linking

1462-3889

Grant Number

(United Kingdom Cancer Research UK)

Language

English

Electronic Date of Publication

20100223

Date of Publication

2010 Jul

Date Created

20100531

Year of Publication

2010

Editors

20100903

Revised Date

20111117

Entry Week

46

20111214

Link to the Ovid Full Text or citation:

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Disclosing a diagnosis of dementia: helping learners to break bad news.

Lee L. Weston WW.

Canadian Family Physician. 57(7):851-2, e270-2, 2011 Jul.

[Journal Article]

UI: 21753111

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Lee, Linda. Weston, W Wayne.

Institution

Centre for Family Medicine Memory Clinic, Ont.

Abbreviated Source

Can Fam Physician. 57(7):851-2, e270-2, 2011 Jul.

NLM Journal Name

Canadian family physician Medecin de famille canadien

Publisher Identifier

Journal available in: Print. Citation processed from: Internet

NLM Journal Code

blo, 0120300

Other ID

Source: NLM. PMC3135455

Journal Subset

IM

Country of Publication

Canada

Emtree Heading

Clinical Competence. *Dementia/di [Diagnosis]. *Family Practice/ed [Education]. Humans. *Internship and Residency. *Physician-Patient Relations/es [Ethics]. *Truth Disclosure.

ISSN Electronic

1715-5258

ISSN Linking

0008-350X

Language

English, French

Date of Publication

47

2011 Jul

Date Created

20110714

Year of Publication

2011

Editors

20111220

Entry Week

20111221

Link to the Ovid Full Text or citation:

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Developing and implementing an advanced communication training program in oncology at a comprehensive cancer center.

Bylund CL. Brown RF. Bialer PA. Levin TT. Lubrano di Ciccone B. Kissane DW.

Journal of Cancer Education. 26(4):604-11, 2011 Dec.

[Journal Article. Research Support, Non-U.S. Gov't]

UI: 21541813

Cancer patients report significant levels of unmet needs in the realm of communication. Communication skills training programs have been shown to improve clinical communication. However, advanced communication skills training programs in oncology have lacked institutional integration, and thus have not attended to institutional norms and cultures that may counteract explicit communication skills training. We developed and implemented an advanced communication skills training program made up of nine teaching modules for faculty, fellows, and residents. Training included didactic and experiential small group work. Self-efficacy and behavior change were assessed for individual participants. Since 2006, 515 clinicians have participated in this training program. Participants have shown significant gains in self-efficacy regarding communicating with patients in various contexts. Our initial work in this area demonstrates the implementation of such a program at a major cancer center to be feasible, to be acceptable, and to have a significant impact on participants' self-efficacy.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Bylund, Carma L. Brown, Richard F. Bialer, Philip A. Levin, Tomer T. Lubrano di Ciccone, Barbara. Kissane, David W.

Institution

Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY 10022, USA. bylundlc@mskcc.org

Abbreviated Source

J Cancer Educ. 26(4):604-11, 2011 Dec.

NLM Journal Name

Journal of cancer education : the official journal of the American Association for Cancer Education

48

Publisher Identifier

Journal available in: Print. Citation processed from: Internet

NLM Journal Code

avy, 8610343

Journal Subset

IM

Country of Publication

England

Emtree Heading

Cancer Care Facilities. *Clinical Competence/st [Standards]. *Communication. *Education, Medical, Continuing/og [Organization & Administration]. *Faculty, Medical/og [Organization & Administration]. *Health Plan Implementation. Humans. *Medical Oncology/ed [Education]. Medical Oncology/st [Standards]. Medical Staff, Hospital/ed [Education]. Medical Staff, Hospital/px [Psychology]. Professional Competence/st [Standards]. Program Evaluation.

ISSN Electronic

1543-0154

ISSN Linking

0885-8195

Language

English

Date of Publication

2011 Dec

Date Created

20111122

Year of Publication

2011

Editors

20120419

Entry Week

20120420

Link to the Ovid Full Text or citation:

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Conversations in end-of-life care: communication tools for critical care practitioners.

Shannon SE. Long-Sutehall T. Coombs M.

Nursing in Critical Care. 16(3):124-30, 2011 May-Jun.

[Journal Article. Research Support, Non-U.S. Gov't]

UI: 21481114

BACKGROUND: Communication skills are the key for quality end-of-life care including in the critical care setting. While learning general, transferable communication skills, such as therapeutic listening, has been common in nursing education, learning specific communication tools, such as breaking bad news, has been the norm for medical education. Critical care nurses may also benefit from learning communication tools that are more

49

specific to end-of-life care.

STRATEGY: We conducted a 90-min interactive workshop at a national conference for a group of 78 experienced critical care nurses where we presented three communication tools using short didactics. We utilized theatre style and paired role play simulation. The Ask-Tell-Ask, Tell Me More and Situation-Background-Assessment-Recommendation (SBAR) tools were demonstrated or practiced using a case of a family member who feels that treatment is being withdrawn prematurely for the patient. The audience actively participated in debriefing the role play to maximize learning. The final communication tool, SBAR, was practiced using an approach of pairing with another member of the audience. At the end of the session, a brief evaluation was completed by 59 nurses (80%) of the audience.

SUMMARY: These communication tools offer nurses new strategies for approaching potentially difficult and emotionally charged conversations. A case example illustrated strategies for applying these skills to clinical situations. The three tools assist critical care nurses to move beyond compassionate listening to knowing what to say. Ask-Tell-Ask reminds nurses to carefully assess concerns before imparting information. Tell Me More provides a tool for encouraging dialogue in challenging situations. Finally, SBAR can assist nurses to distill complex and often long conversations into concise and informative reports for colleagues. Copyright 2011 The Authors. Nursing in Critical Care Copyright 2011 British Association of Critical Care Nurses.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Shannon, Sarah E. Long-Sutehall, Tracy. Coombs, Maureen.

Institution

Biobehavioral Nursing & Health Systems, Box 357266, University of Washington, Seattle, WA 98195-7266, USA. sshannon@uw.edu

Abbreviated Source

Nurs Crit Care. 16(3):124-30, 2011 May-Jun.

NLM Journal Name

Nursing in critical care

Publisher Identifier

Journal available in: Print. Citation processed from: Internet

NLM Journal Code

9808649, c3k

Journal Subset

N

Country of Publication

England

Emtree Heading

Attitude of Health Personnel. *Communication. Critical Care/mt [Methods]. Critical Care/px [Psychology]. Decision Making. Family/px [Psychology]. Humans. Nurse-Patient Relations. Nursing Staff/px [Psychology]. *Terminal Care/mt [Methods]. *Terminal Care/px [Psychology].

ISSN Electronic

1478-5153

ISSN Linking

50

1362-1017

DOI

http://dx.doi.org/10.1111/j.1478-5153.2011.00456.x

Language

English

Date of Publication

2011 May-Jun

Date Created

20110412

Year of Publication

2011

Editors

20110829

Entry Week

20111214

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Comparison of patients' needs and doctors' perceptions of information requirements related to a diagnosis of oesophageal or gastric cancer.

Wittmann E., Beaton C., Lewis W.G., Hopper A.N., Zamawi F., Jackson C., Dave B., Bowen R., Willacombe A., Blackshaw G., Crosby T.D.L.

European Journal of Cancer Care. 20 (2) (pp 187-195), 2011. Date of Publication: March 2011.

[Journal: Article]

AN: 20345454

The aim of this study was to assess the information needs of patients diagnosed with oesophageal and gastric cancer and to compare these with their perceived information needs in the opinion of junior doctors. One hundred patients and 100 doctors responded to a questionnaire regarding the information needs of cancer patients. Seventy-nine per cent of patients wanted as much information as possible about their diagnosis, but only 35% of doctors were willing to give all the available information (P < 0.0001). Seventy-seven per cent of patients wanted to receive their diagnosis from a consultant whereas only 5% of doctors believed that patients should receive their diagnoses from a consultant (P < 0.0001). Eighty-four per cent of doctors were willing to communicate a serious illness with a good prognosis, yet only 43% would communicate a diagnosis with a poor prognosis (P < 0.0001). All 100 doctors had received formal training in breaking bad news, but 20 considered this inadequate. Socio-economic deprivation was associated with poor access to supplementary Internet derived information (P < 0.001). The majority of patients with a diagnosis of oesophagogastric cancer want a great deal of information regarding their illness, which contrasts with doctors' perceptions. Adequate training in information disclosure may help address this issue. 2010 Blackwell Publishing Ltd.

Institution

(Wittmann) South East Wales Upper GI Cancer Network, Department of Surgery, University Hospital of Wales, Cardiff, United Kingdom (Beaton) South East Wales Upper GI Cancer Network, Department of Surgery, University Hospital of Wales, Cardiff, United Kingdom

(Lewis) South East Wales Upper GI Cancer Network, Department of Surgery, University Hospital of Wales, Cardiff, United Kingdom

51

(Hopper) South East Wales Upper GI Cancer Network, Department of Surgery, University Hospital of Wales, Cardiff, United Kingdom

(Zamawi) South East Wales Upper GI Cancer Network, Department of Surgery, University Hospital of Wales, Cardiff, United Kingdom

(Jackson) South East Wales Upper GI Cancer Network, Department of Surgery, University Hospital of Wales, Cardiff, United Kingdom

(Dave) South East Wales Upper GI Cancer Network, Department of Surgery, University Hospital of Wales, Cardiff, United Kingdom

(Bowen) Royal Glamorgan Hospital, Llantrisant, United Kingdom

(Willacombe) South East Wales Upper GI Cancer Network, Department of Surgery, University Hospital of Wales, Cardiff, United Kingdom

(Blackshaw) South East Wales Upper GI Cancer Network, Department of Surgery, University Hospital of Wales, Cardiff, United Kingdom

(Crosby) Velindre Hospital, Cardiff, United Kingdom

Correspondence Address

W.G. Lewis, Consultant Surgeon, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, United Kingdom. E-mail: wyn.lewis@cardiffandvale.wales.nhs.uk

Country of Publication

United Kingdom

Publisher

Blackwell Publishing Ltd

Keyword

Breaking bad news, Communication, Gastric cancer, Information, Oesophageal cancer

Emtree Heading

adult; aged; article; cohort analysis; *doctor patient relation; *esophagus tumor/di [Diagnosis]; female; *health personnel attitude; human; *interpersonal communication; male; medical staff; middle aged; needs assessment; patient education; *patient preference; psychological aspect; questionnaire; *stomach tumor/di [Diagnosis].

Number of References

22

ISSN

0961-5423

Electronic ISSN

1365-2354

DOI

http://dx.doi.org/10.1111/j.1365-2354.2009.01169.x

Language

English

Summary Language

English

Entry Week

201100

Date Delivered

20110530

Year of Publication

52

2011

Copyright

MEDLINE is the source for the citation and abstract of this record.

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Communication skills training for oncology professionals. [Review]

Kissane DW. Bylund CL. Banerjee SC. Bialer PA. Levin TT. Maloney EK. D'Agostino TA.

Journal of Clinical Oncology. 30(11):1242-7, 2012 Apr 10.

[Journal Article. Research Support, N.I.H., Extramural. Review]

UI: 22412145

PURPOSE: To provide a state-of-the-art review of communication skills training (CST) that will guide the establishment of a universal curriculum for fellows of all cancer specialties undertaking training as oncology professionals today.

METHODS: Extensive literature review including meta-analyses of trials, conceptual models, techniques, and potential curricula provides evidence for the development of an appropriate curriculum and CST approach. Examples from the Memorial Sloan-Kettering Cancer Center CST program are incorporated.

RESULTS: A core curriculum embraces CST modules in breaking bad news and discussing unanticipated adverse events, discussing prognosis, reaching a shared treatment decision, responding to difficult emotions, coping with survivorship, running a family meeting, and transitioning to palliative care and end of life. Achievable outcomes are growth in clinician's self-efficacy, uptake of new communication strategies and skills, and transfer of these strategies and skills into the clinic. Outcomes impacting patient satisfaction, improved adaptation, and enhanced quality of life are still lacking.

CONCLUSION: Future communication challenges include genetic risk communication, concepts like watchful waiting, cumulative radiation risk, late effects of treatment, discussing Internet information and unproven therapies, phase I trial enrollment, and working as a multidisciplinary team. Patient benefits, such as increased treatment adherence and enhanced adaptation, need to be demonstrated from CST.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Kissane, David W. Bylund, Carma L. Banerjee, Smita C. Bialer, Philip A. Levin, Tomer T. Maloney, Erin K. D'Agostino, Thomas A.

Institution

Memorial Sloan-Kettering Cancer Center, New York, NY 10022, USA. kissaned@mskcc.org

Abbreviated Source

J Clin Oncol. 30(11):1242-7, 2012 Apr 10.

NLM Journal Name

Journal of clinical oncology : official journal of the American Society of Clinical Oncology

Publisher Identifier

Journal available in: Print-Electronic. Citation processed from: Internet

NLM Journal Code

53

jco, 8309333

Other ID

Source: NLM. PMC3341141 [Available on 04/10/13]

Journal Subset

IM

Country of Publication

United States

Emtree Heading

Adaptation, Psychological. *Communication. Curriculum. Humans. *Medical Oncology. Meta-Analysis as Topic.

ISSN Electronic

1527-7755

ISSN Linking

0732-183X

Grant Number

R25 CA134252 (United States NCI NIH HHS)

Language

English

Electronic Date of Publication

20120312

Date of Publication

2012 Apr 10

Date Created

20120411

Year of Publication

2012

Editors

20120530

Entry Week

20120531

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Commentary on "teaching breaking bad news using mixed reality simulation".

Gould JC.

Journal of Surgical Research. 158(1):35, 2010 Jan.

[Journal Article]

UI: 19691977

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

54

MEDLINE

Authors Full Name

Gould, Jon C.

Institution

University of Wisconsin, School of Medicine and Public Health, K4/762 Clinical Science Center, Madison, WI 53593, USA. gould@sugery.wisc.edu

Abbreviated Source

J Surg Res. 158(1):35, 2010 Jan.

NLM Journal Name

The Journal of surgical research

Publisher Identifier

Journal available in: Print-Electronic. Citation processed from: Internet

NLM Journal Code

k7b, 0376340

Journal Subset

IM

Country of Publication

United States

Emtree Heading

*Communication. Humans. *Physician-Patient Relations. *Teaching. *Truth Disclosure.

ISSN Electronic

1095-8673

ISSN Linking

0022-4804

Language

English

Date of Publication

2010 Jan

Date Created

20091216

Year of Publication

2010

Editors

20100107

Entry Week

20111214

Link to the Ovid Full Text or citation:

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Breaking bad news: the patient's viewpoint.

Munoz Sastre MT. Sorum PC. Mullet E.

55

Health Communication. 26(7):649-55, 2011 Oct.

[Journal Article]

UI: 21598151

The objective of this study was to ascertain how patients judge the acceptability of physicians' communication of bad news. Two hundred forty-five adults, who had in the past received bad medical news, indicated the acceptability of physicians' conduct in 48 vignettes of giving bad news to patients. Vignettes were all combinations of five factors: level of bad news (infection with hepatitis C, cirrhosis of the liver, or liver cancer); request or not to the patient to come with spouse or partner; attempt or not by the physician to find out the patient's expectations about the test results; presence or absence of emotional supportiveness; and provision or not of complete and understandable information. In addition, nine physicians rated the same vignettes. Quality of information and emotional supportiveness explained more than 95% of the variance in patients' acceptability judgments, while the degree of badness of the news had no impact. In addition, for patients, low emotional supportiveness could not be fully compensated by high quality of information, nor the inverse. Physicians, in contrast, responded as if such compensations were possible. Physicians must appreciate that patients expect high levels of both empathy and information quality, no matter how bad the news.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Munoz Sastre, Maria Teresa. Sorum, Paul Clay. Mullet, Etienne.

Institution

Department of Health Psychology, University of Mirail, Toulouse, France.

Abbreviated Source

Health Commun. 26(7):649-55, 2011 Oct.

NLM Journal Name

Health communication

Publisher Identifier

Journal available in: Print-Electronic. Citation processed from: Internet

NLM Journal Code

dr9, 8908762

Journal Subset

IM

Country of Publication

England

Emtree Heading

Adolescent. Adult. *Communication. *Emotions. Empathy. Female. Humans. Japan. Male. *Patient Satisfaction. Physician-Patient Relations. *Physicians. Severity of Illness Index. Sex Factors. Social Support. *Truth Disclosure. Young Adult.

ISSN Electronic

1532-7027

ISSN Linking

1041-0236

Language

56

English

Electronic Date of Publication

20110523

Date of Publication

2011 Oct

Date Created

20111014

Year of Publication

2011

Editors

20120209

Entry Week

20120210

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Breaking bad news: exploring patient's perspective and expectations.

Ishaque S. Saleem T. Khawaja FB. Qidwai W.

JPMA - Journal of the Pakistan Medical Association. 60(5):407-11, 2010 May.

[Journal Article]

UI: 20527623

OBJECTIVE: To explore patient's perspectives and expectations from physicians with respect to breaking of bad news.

METHODS: A cross-sectional survey was carried out in the Community Health Centre of a tertiary care teaching hospital in Pakistan. All consenting individuals from 18 to 60 years of age were interviewed on the basis of a structured, pre-tested questionnaire.

RESULTS: The response rate for this study was 91.3%. A total of 400 respondents completed the full interview. About 60% patients had a fairly accurate idea about the implications of the phrase "bad news". A big proportion (44.1%) of people reported that bad news had been broken to them previously with incomplete details. From their personal experience, most respondents quoted "disease diagnosis" and "chances of survival" as most commonly encountered bad news. Diagnosis of cancer or its recurrence was stated as the most likely example of bad news (35.5%). A significant majority of respondents (40.5%) stated that it's the patient's absolute right to know bad news. A significant association for the relationship between both age as well as the gender of the respondents and type of emotional response expressed on hearing bad news (p = 0.000) was observed.

CONCLUSION: This study documents the perceptions and expectations of patients from their physicians with regards to breaking of bad news. Most of the respondents wanted their doctors to be honest and upfront during the process.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Ishaque, Sidra. Saleem, Taimur. Khawaja, Fariha Batool. Qidwai, Waris.

57

Institution

Medical College, The Aga Khan University Hospital, Karachi.

Abbreviated Source

JPMA J Pak Med Assoc. 60(5):407-11, 2010 May.

NLM Journal Name

JPMA. The Journal of the Pakistan Medical Association

Publisher Identifier

Journal available in: Print. Citation processed from: Print

NLM Journal Code

7503100, 7501162, kgi

Journal Subset

IM

Country of Publication

Pakistan

Emtree Heading

Adolescent. Adult. Aged. Aged, 80 and over. Attitude of Health Personnel. Cross-Sectional Studies. Female. *Health Knowledge, Attitudes, Practice. Hospitals, University. Humans. Male. Middle Aged. Neoplasms/di [Diagnosis]. Neoplasms/px [Psychology]. *Neoplasms. Pakistan. Patient Satisfaction. Perception. *Physician's Role/px [Psychology]. *Physician-Patient Relations. Questionnaires. *Truth Disclosure. Young Adult.

ISSN

0030-9982

ISSN Linking

0030-9982

Language

English

Date of Publication

2010 May

Date Created

20100609

Year of Publication

2010

Editors

20100701

Entry Week

20111214

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Breaking bad news: communication skills for difficult conversations.

Davenport L., Schopp G.

58

JAAPA : official journal of the American Academy of Physician Assistants. 24 (2) (pp 46-50), 2011. Date of Publication: Feb 2011.

[Journal: Article]

AN: 21387970

Institution

(Davenport) South University, Savannah, Georgia, USA.

Correspondence Address

L. Davenport, South University, Savannah, Georgia, USA.

Country of Publication

United States

Emtree Heading

article; human; *human relation; *interpersonal communication; religion.

ISSN

1547-1896

Language

English

Entry Week

201100

Date Delivered

20110426

Year of Publication

2011

Copyright

MEDLINE is the source for the citation and abstract of this record.

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Breaking bad news: an interview study of paediatric cardiologists.

Birkeland AL. Dahlgren L. Hagglof B. Rydberg A.

Cardiology in the Young. 21(3):286-91, 2011 Jun.

[Journal Article. Research Support, Non-U.S. Gov't]

UI: 21272428

UNLABELLED: Technical developments in paediatric cardiology over the last few decades have increased expectations on professionals, demanding of them more emotional competence and communicative ability. The aim of this study was to examine the approach of paediatric cardiologists in informing and communicating with the family of the patient.

METHOD: A qualitative interview method was first tested in a pilot study with two paediatric cardiologists. There were nine subsequent semi-structured interviews that were carried out with paediatric cardiologists. A researcher performed all the interviews, which were taped, transcribed, decoded, and analysed.

RESULTS: Among paediatric cardiologists, how to break bad news to the family is an important concern, evident in findings regarding the significance of trust and confidence, the use of different emotional positions, and a common ambition to achieve skills to handle the situation. There is a need for reflection, education, and sharing of experiences. The

59

cardiologists desire further development of teamwork and of skills in medical students and residents for delivering bad news.

CONCLUSIONS: Doctors are expected to cope with the complexities of diagnoses and decisions, while simultaneously being sensitive to the feelings of the parents, aware of their own emotions, and able to keep it all under control in the context of breaking the bad news to the parents and keeping them informed. These conflicting demands create a need to expand the professional role of the doctor by including more training in emotional competence and communicative ability, beginning in medical school and continuing through consultancy.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Birkeland, Anna-Lena. Dahlgren, Lars. Hagglof, Bruno. Rydberg, Annika.

Institution

Division of Paediatrics, Department of Clinical Sciences, Umea University, Umea, Sweden.

Abbreviated Source

Cardiol Young. 21(3):286-91, 2011 Jun.

NLM Journal Name

Cardiology in the young

Publisher Identifier

Journal available in: Print-Electronic. Citation processed from: Internet

NLM Journal Code

9200019, C4T

Journal Subset

IM

Country of Publication

England

Emtree Heading

Academic Medical Centers. *Attitude of Health Personnel. Cardiology. *Heart Defects, Congenital/px [Psychology]. Humans. Interviews as Topic. *Parents/px [Psychology]. Pediatrics. *Physician's Role/px [Psychology]. *Physician-Patient Relations. Physicians/px [Psychology]. Pilot Projects. *Professional-Family Relations. Prognosis. Sweden.

ISSN Electronic

1467-1107

ISSN Linking

1047-9511

Language

English

Electronic Date of Publication

20110128

Date of Publication

2011 Jun

Date Created

60

20110826

Year of Publication

2011

Editors

20120301

Entry Week

20120302

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Breaking bad news: a guide for effective and empathetic communication.

Rosenzweig M.Q.

The Nurse practitioner. 37 (2) (pp 1-4), 2012. Date of Publication: 12 Feb 2012.

[Journal: Article]

AN: 22252021

Breaking negative news to patients is a common occurrence for nurse practitioners. This difficult task requires patience and refined communication skills, and must be approached with empathy for all parties involved. There are several ways to deliver bad news to patients successfully using patient-centered communication techniques and methods.

Institution

(Rosenzweig) University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.

Correspondence Address

M.Q. Rosenzweig, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.

Country of Publication

United States

Emtree Heading

article; clinical competence; empathy; health personnel attitude; human; *interpersonal communication; *life event; methodology; *nurse patient relationship; nurse practitioner; nursing evaluation research; nursing methodology research; *patient care; practice guideline; psychological aspect.

Electronic ISSN

1538-8662

Language

English

Entry Week

201216

Date Delivered

20120412

Year of Publication

2012

Copyright

MEDLINE is the source for the citation and abstract of this record.

61

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Breaking bad news to people with intellectual disabilities.

Tuffrey-Wijne I., Giatras N., Butler G., Cresswell A.

Journal of Intellectual Disability Research. Conference: 14th World Congress of the International Association for the Scientific Study of Disabilities, IASSID 2012 Halifax, NS Canada. Conference Start: 20120709 Conference End: 20120714. Conference Publication: (var.pagings). 56 (7-8) (pp 663), 2012. Date of Publication: July 2012.

[Journal: Conference Abstract]

AN: 70808660

Aim: Current models for breaking bad news are inadequate in meeting the needs of people with intellectual disabilities (ID). This study explored the experiences and preferences of people with ID, families and professionals to identify the factors that affect breaking bad news to people with ID. Methods: Individual interviews and focus groups were conducted with 109 participants across England. Participants included people with ID, family carers, general nurses, physicians and ID professionals. Results: Results revealted that (a) people with ID have wide-ranging views about whether and how they want to be told bad news; (b) professionals lack confidence in communicating bad news to people with ID; (c) many family carers want to protect people with ID from bad news; and (d) bad news should be given in chunks, depending on the person's abilities and needs. Most people with ID make sense of bad news within their social context, rather than in a doctor's office. Conclusion: Rather than "breaking bad news", the key is to help someone understand and cope with a changing situation. This is a gradual process. A new model for breaking bad news to people with ID has been produced and will be presented as a poster.

Institution

(Tuffrey-Wijne) St George's University of London, United Kingdom

Correspondence Address

I. Tuffrey-Wijne, St George's University of London, United Kingdom. E-mail: ituffrey@sgul.ac.uk

Publisher

Blackwell Publishing Ltd

Emtree Heading

*human; *intellectual impairment; *disability; model; physician; information processing; social environment; nurse; United Kingdom; interview.

ISSN

0964-2633

DOI

http://dx.doi.org/10.1111/j.1365-2788.2012.01583_2.x

Language

English

Summary Language

English

Entry Week

201230

Date Delivered

20120717

62

Year of Publication

2012

Copyright

Copyright 2012 Elsevier B.V., All rights reserved.

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Breaking bad news in onco-hematology: New hope, new words?.

Aitini E.

Leukemia and Lymphoma. 53 (2) (pp 328-329), 2012. Date of Publication: February 2012.

[Journal: Letter]

AN: 2012047508

Institution

(Aitini) Carlo Poma Hospital, Oncology and Hematology, via Lago Paiolo, Mantova, 46100, Italy

Correspondence Address

E. Aitini, Carlo Poma Hospital, Oncology and Hematology, via Lago Paiolo, Mantova, 46100, Italy. E-mail: enrico.aitini@aopoma.it

Country of Publication

United Kingdom

Publisher

Informa Healthcare (69-77 Paul Street, London EC2A 4LQ, United Kingdom)

Emtree Heading

cancer research; doctor patient relation; *hematologic malignancy; human; letter; medical research; priority journal.

Number of References

5

Embase Section Headings

Cancer [16], Public Health, Social Medicine and Epidemiology [17], Hematology [25]

ISSN

1042-8194

Electronic ISSN

1029-2403

DOI

http://dx.doi.org/10.3109/10428194.2011.608454

CODEN

LELYE

Language

English

Entry Week

201205

63

Date Delivered

20120201

Year of Publication

2012

Copyright

Copyright 2012 Elsevier B.V., All rights reserved.

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Breaking bad news in inpatient clinical settings: Role of the nurse.

Warnock C., Tod A., Foster J., Soreny C.

Journal of Advanced Nursing. 66 (7) (pp 1543-1555), 2010. Date of Publication: July 2010.

[Journal: Article]

AN: 20492016

warnock c., tod a., foster j. & soreny c. (2010) Breaking bad news in inpatient clinical settings: role of the nurse. Journal of Advanced Nursing 66(7), 1543-1555. Title.: Breaking bad news in inpatient clinical settings: role of the nurse. Aim.: This paper is a report of an exploration of the role of the nurse in the process of breaking bad news in the inpatient clinical setting and the provision of education and support for nurses carrying out this role. Background.: The term 'breaking bad news' is mostly associated with the moment when negative medical information is shared with a patient or relative. However, it can also be seen as a process of interactions that take place before, during and after bad news is broken. Little research has been conducted exploring the role of the nurse in the process of breaking bad news in the inpatient clinical setting. Methods.: A questionnaire was developed using Likert scales and open text questions. Data collection took place in 2007. Fifty-nine inpatient areas took part in the study; 335 questionnaires were distributed in total and 236 were completed (response rate 70%). Results.: Nurses engaged in diverse breaking bad news activities at many points in care pathways. Relationships with patients and relatives and uncontrolled and unplanned events shaped the context in which they provided this care. Little formal education or support for this work had been received. Conclusion.: Guidance for breaking bad news should encompass the whole process of doing this and acknowledge the challenges nurses face in the inpatient clinical area. Developments in education and support are required that reflect the challenges that nurses encounter in the inpatient care setting. 2010 The Authors. Journal compilation 2010 Blackwell Publishing Ltd.

Institution

(Warnock) Weston Park Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom (Tod) Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, United Kingdom

(Foster) Gynaecology and Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, United Kingdom

(Soreny) Opthalmic Assessment Nurse Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, United Kingdom

Correspondence Address

C. Warnock, Weston Park Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom. E-mail: clare.warnock@sth.nhs.uk

Country of Publication

United Kingdom

Publisher

Blackwell Publishing Ltd (9600 Garsington Road, Oxford OX4 2XG, United Kingdom)

64

Keyword

Breaking bad news, Clinical settings, Inpatients, Nurse

Emtree Heading

article; clinical competence; family; human; *interpersonal communication; life event; *nurse attitude; nurse patient relationship; nursing education; *nursing staff; psychological aspect; questionnaire; standard.

Number of References

28

ISSN

0309-2402

Electronic ISSN

1365-2648

DOI

http://dx.doi.org/10.1111/j.1365-2648.2010.05325.x

CODEN

JANUD

Language

English

Summary Language

English

Entry Week

201202

Date Delivered

20120109

Year of Publication

2010

Copyright

MEDLINE is the source for the citation and abstract of this record.

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Breaking bad news in bipolar disorders: An interview study of patients and physicians.

Montel S., Spitz E.

Bipolar Disorders. Conference: 5th Biennial Conference of the International Society for Bipolar Disorders Istanbul Turkey. Conference Start: 20120314 Conference End: 20120317. Conference Publication: (var.pagings). 14 (pp 106), 2012. Date of Publication: March 2012.

[Journal: Conference Abstract]

AN: 70695677

Introduction: Research on the breaking bad news mainly focused on cancer disease. Few studies investigated this issue in mental diseases like bipolar disorders. We are exploring factors influencing the breaking bad news process in bipolar disorders. Methods: Patients and physicians involved in bipolar disorders are interviewed. Patients/physicians are considering eligible if they received/broke bad news in the few months preceding the

65

interview. A semi-structured interview is conducted by psychologists. The main issues tackled are: needs, emotions, cognition, behavior/ attitude before, during and after the breaking. TA will be used as data analysis. Results: We are proceeding to do the interviews of both patients and physicians. We will display the first results of this study during the ISBD meeting. Discussion: These qualitative data should help us to respond to the needs of the bipolar disorder's patients as well as those of the physicians who have to break them bad news.

Institution

(Montel, Spitz) University Paul Verlaine, Metz, France (Montel, Spitz) Laboratory APEMAC, Paris, Nancy, Metz, France

Correspondence Address

S. Montel, University Paul Verlaine, Metz, France

Publisher

Wiley Blackwell

Keyword

Breaking bad news, Bipolar disorders, Patients, Physicians

Emtree Heading

*human; *interview; *bipolar disorder; *physician; *patient; *society; semi structured interview; psychologist; emotion; cognition; data analysis; mental disease; neoplasm.

ISSN

1398-5647

DOI

http://dx.doi.org/10.1111/j.1399-5618.2012.00981.x

Language

English

Summary Language

English

Entry Week

201213

Date Delivered

20120321

Year of Publication

2012

Copyright

Copyright 2012 Elsevier B.V., All rights reserved.

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Breaking bad news during prenatal care: a challenge to be tackled.

Guerra FA. Mirlesse V. Baiao AE.

Ciencia & Saude Coletiva. 16(5):2361-7, 2011 May.

[Journal Article]

UI: 21655706

66

Communicating an unfavorable diagnosis during prenatal care is a growing challenge in clinical practice, as more and more tests are being performed to screen for the main conditions affecting the pregnant woman and her fetus. The way patients receive and subsequently deal with bad news is directly influenced by how the news is communicated by the attending physician. Unfortunately, physicians receive little or no training in communicating bad news, and they generally feel quite uncomfortable about doing so. Although many physicians consider the saying that "there's no good way to break bad news" to be the truth, the maxim does not reflect the true picture. The scope of this article is to discuss, in light of the scientific literature and the experience of fetal medicine services, some recommendations that can help to deal with these difficult moments and improve patient care for the remainder of the pregnancy.

Record Owner

From MEDLINE, a database of the U.S. National Library of Medicine.

Stage

MEDLINE

Authors Full Name

Guerra, Fernando Antonio Ramos. Mirlesse, Veronique. Baiao, Ana Elisa Rodrigues.

Institution

Departamento deObstetricia, InstitutoFernandes Figueira, Fundacao Oswaldo Cruz. Av. Rui Barbosa 716, 3o andar, Setor de Medicina Fetal, Flamengo. 22250-020 Rio de Janeiro RJ. ramosguerra@uol.com.br

Comments

Comment in: Cien Saude Colet. 2011 May;16(5):2368-9; author reply 2370-1; PMID: 21655707, Comment in: Cien Saude Colet. 2011 May;16(5):2369-70; author reply 2370-1; PMID: 21655708

Abbreviated Source

Cienc. saude colet.. 16(5):2361-7, 2011 May.

NLM Journal Name

Ciencia & saude coletiva

Publisher Identifier

Journal available in: Print. Citation processed from: Internet

NLM Journal Code

9713483

Journal Subset

IM

Country of Publication

Brazil

Emtree Heading

Attitude of Health Personnel. Female. Humans. Physician-Patient Relations. Pregnancy. *Prenatal Care. Prenatal Diagnosis. *Truth Disclosure.

ISSN Electronic

1678-4561

ISSN Linking

1413-8123

Publisher Item Identifier

S1413-81232011000500002

Language

67

English

Date of Publication

2011 May

Date Created

20110609

Year of Publication

2011

Editors

20111027

Entry Week

20111214

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Breaking bad news - What patients want and what they get.

Seifart U., Bar T., Stumpenhorst M., Riera-Knorrenschild J., Seifart C.

Onkologie. Conference: Jahrestagung der Deutschen, Osterreichischen und Schweizerischen Gesellschaften fur Hamatologie und Onkologie 2011 Basel Switzerland. Conference Start: 20110930 Conference End: 20111004. Conference Publication: (var.pagings). 34 (pp 46), 2011. Date of Publication: September 2011.

[Journal: Conference Abstract]

AN: 70568749

Introduction: Breaking bad news is one of the most difficult duties of physicians, especially in hematology-oncology. On the one hand there are no data available about how physicians break bad news in Germany. On the other hand, patient's preferences for breaking bad news are not well known. Methods: We developed a questionnaire leant on the SPIKES-protocol, which includes the perceived reality of the first time bad news had been broken to cancer patients and evaluates every single step of the SPIKES-protocol. Additionally the questionnaire asks for patient's preferences, including individual expectations, self-government in this situation and the emotional response of each patient. Between 10/ 2010 and 1/2011 all patients suffer from cancer in the oncology department of a university hospital and in a cancer rehabilitation clinic were asked to complete the questionnaire. The questionnaire was answered by 370 patients with prior diagnosed cancer. Results: Overall only 46,1% of all patients were thoroughly satisfied how they had been broken the diagnosis of cancer. There is a statistical significant correlation of the quality of how the bad news had been broken and the metal state of the patient after their conversation with their doctor (rs = -.261, p < .001). Concerning patients' preferences a well-defined list of precedence could be established, with "understanding the diagnosis", "adequate time", "the possibility to ask question" and "reassure understanding" being on the top of the list. For all of the ten most important patient's preferences, high significant differences between patient's wishes and the experienced reality could be shown. Conclusion: The study show that the quality of how bad news are broken is correlated to patients mental state and that its quality should be optimized. Furthermore it makes evident that there is an impressive gap between the way bad news are broken and patient's preferences.

Institution

(Seifart) Klinik Sonnenblick, Onkologie, Marburg, Germany (Bar) Universitatsklinikum Giessen und Marburg GmbH, Standort Marburg; Ethikommission, AG Klinische Ethik, Marburg, Germany

(Stumpenhorst) Philipps-Universitat Marburg, Fachbereich Psychologie, AG Klinische Psychologie und Psychotherapie, Marburg, Germany

68

(Riera-Knorrenschild, Seifart) Universitatsklinikum Giessen und Marburg GmbH, Standort Marburg; Abteilung Hamatologie und Onkologie, Marburg, Germany

Correspondence Address

U. Seifart, Klinik Sonnenblick, Onkologie, Marburg, Germany

Publisher

S. Karger AG

Emtree Heading

*human; *patient; questionnaire; patient preference; neoplasm; physician; oncology; diagnosis; rehabilitation center; mental health; conversation; hematology; Germany; cancer patient; government; emotion; university hospital; cancer rehabilitation; metal.

ISSN

0378-584X

DOI

http://dx.doi.org/10.1159/000333299

Language

English

Summary Language

English

Entry Week

201100

Date Delivered

20111103

Year of Publication

2011

Copyright

Copyright 2011 Elsevier B.V., All rights reserved.

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Breaking bad news - Perceptions of cancer patients and their relatives.

Jameel A., Farooq M., Ullah S.

JPMI - Journal of Postgraduate Medical Institute. 25 (4) (pp 304-308), 2011. Date of Publication: 2011.

[Journal: Article]

AN: 2012512248

Objective: To study the perceptions of cancer patients and their relatives regarding disclosure of cancer related information. Methodology: A cross sectional survey was conducted at Medical Oncology Ward, Hayatabad Medical Complex, Peshawar from September 2009 to January 2011. A total of 114 patients and their relatives were interviewed using a pre-designed questionnaire. Results: Eighty Three (73%) were male while 31 (27%) were female. Median age of cancer patients was 36 (18-70) years. Forty-eight percent (29/60) cancer patients wished for full disclosure of bad news while 39% (21/54) of their relatives wanted full disclosure (p= Not Significant). Sixty two percent (37/60) cancer patients and 74% (40/54) relatives wanted to be informed in case of recurrence (p= Not Significant). Over 90% of patients and relatives wanted bad news to be broken by a senior consultant. Fifty eight percent (35/60) cancer patients and 52% (28/54) relatives

69

wished for their relatives to make treatment decisions for them (p= Not Significant). However, 93% (56/60) of cancer patients and 78% (42/54) of their relatives wanted full information about all side-effects of treatment (p < 0.02). Fifty eight percent (35/60) cancer patients and 32% (17/54) relatives wanted their close relatives to be present while bad news was being broken (p<0.007). Conclusion: Almost half of patients wished for full disclosure of information regarding cancer diagnosis. Over 90% patients wanted full information regarding all side-effects of chemotherapy. It is recommended that training regarding how to break bad news be made mandatory part of our medical training both at undergraduate and postgraduate levels.

Institution

(Jameel, Farooq, Ullah) Department of Medical Oncology, Hayatabad Medical Complex, Peshawar, Pakistan

Correspondence Address

A. Jameel, Department of Medical Oncology, Hayatabad Medical Complex, Peshawar, Pakistan. E-mail: ajameel99@yahoo.com

Country of Publication

Pakistan

Publisher

Postgraduate Medical Institute (Lady Reading Hospital, Peshawar, Pakistan)

Keyword

Breaking bad news, Cancer patient perceptions, Communication skills, Pakistan

URL

http://www.jpmi.org.pk/index.php/jpmi/article/view/1137/1046

Emtree Heading

adult; aged; article; cancer diagnosis; cancer patient; cancer recurrence; cancer therapy; clinical decision making; cross-sectional study; female; human; *information dissemination; *interpersonal communication; major clinical study; male; *medical information; Pakistan; *patient attitude; *perception; relative; structured interview; treatment outcome.

Number of References

23

Embase Section Headings

Cancer [16], Public Health, Social Medicine and Epidemiology [17]

ISSN

1013-5472

Language

English

Summary Language

English

Entry Week

201237

Date Delivered

20120911

Year of Publication

2011

Copyright

Copyright 2012 Elsevier B.V., All rights reserved.

70

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Breaking bad news.

Kachewar S.G., Sankaye S.B.

Australasian Medical Journal. 5 (6) (pp 324-325), 2012. Date of Publication: 2012.

[Journal: Letter]

AN: 2012449315

Institution

(Kachewar, Sankaye) Rural Medical College, Pravara Institute of Medical Sciences (DU), Loni, India

Correspondence Address

S. G. Kachewar, Rural Medical College, Pravara Institute of Medical Sciences (DU), Loni, India. E-mail: sushilkachewar@hotmail.com

Country of Publication

Australia

Publisher

Australasian Medical Journal Pty Ltd (12 Lancett Crt, Sorrento, WA 6020 WA, Australia)

URL

http://www.amj.net.au/index.php?journal=AMJ&page=article&op=view&path%5B%5D=1389&path%5B%5D=945

Emtree Heading

cancer diagnosis; clinical decision making; *communication skill; disease course; genetic disorder; health care personnel; hospice care; human; letter; *medical education; patient information; patient satisfaction; recurrent disease; resuscitation; treatment failure.

Number of References

4

Embase Section Headings

Public Health, Social Medicine and Epidemiology [17]

ISSN

1836-1935

Language

English

Entry Week

201233

Date Delivered

20120814

Year of Publication

2012

Copyright

Copyright 2012 Elsevier B.V., All rights reserved.

71

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Breaking bad news.

Han J., Kagan A.R.

American Journal of Clinical Oncology: Cancer Clinical Trials. 35 (4) (pp 309-310), 2012. Date of Publication: August 2012.

[Journal: Editorial]

AN: 2012442272

Institution

(Han) Kaiser Permanente, Los Angeles Medical Center, Los Angeles, CA 90027, United States (Kagan) Southern California Permanente, Medical Group, Los Angeles Medical Center, Los Angeles, CA, United States

Correspondence Address

J. Han, Kaiser Permanente, Los Angeles Medical Center, Los Angeles, CA 90027, United States. E-mail: jeannie.x.han@kp.org

Country of Publication

United States

Publisher

Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327, Philadelphia PA 19106-3621, United States)

Emtree Heading

cancer palliative therapy; cancer patient; cancer prognosis; *doctor patient relation; dying; editorial; hospice care; human; informed consent; medical information; *terminal care.

Number of References

2

Embase Section Headings

Cancer [16], Public Health, Social Medicine and Epidemiology [17]

ISSN

0277-3732

Electronic ISSN

1537-453X

DOI

http://dx.doi.org/10.1097/COC.0b013e31825eb235

CODEN

AJCOD

Language

English

Entry Week

201233

Date Delivered

20120809

Year of Publication

72

2012

Copyright

Copyright 2012 Elsevier B.V., All rights reserved.

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Beyond dying: Illness descriptions of patients with advanced medical illness.

Morris D., Johnson K., Steinhauser K.

Journal of Pain and Symptom Management. Conference: Annual Assembly of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association 2012 Denver, CO United States. Conference Start: 20120307 Conference End: 20120310. Conference Publication: (var.pagings). 43 (2) (pp 342-343), 2012. Date of Publication: February 2012.

[Journal: Conference Abstract]

AN: 70647427

Objectives 1. Recognize common themes in patients' responses to the clinical questions "What is your understanding of your illness?" and "What has your doctor told you about the future course of your illness?" 2. Discuss implications of these responses for cancer and non-cancer patients. 3. Identify physician-patient communication strategies based on these findings that enhance opportunities for information sharing and partnering with patients across the disease trajectory. Background. Communication guidelines stress using open-ended questions to explore patients' perceptions of illness and prognosis. Questions like "What is your understanding of your illness?" are used by clinicians in breaking bad news with cancer patients or addressing code status at the end-of-life but have not been well studied in other disease groups or earlier in the disease trajectory. Research objectives. Analyze responses to the questions "What is your understanding of your illness?" and "What has your doctor told you about the future course of your illness?" among advanced cancer and non-cancer patients. Method. Qualitative analysis of 210 patients' responses to queries of illness understanding. Responses were recorded at the baseline interview of a larger, longitudinal study of patients with advanced life-limiting illness. After coding emergent themes, investigators conducted pattern analysis to examine variation associated with diagnosis and demographics. Result. 210 subjects included 70 patients with cancer, CHF, or COPD, with a mean age of 66 years. Major themes identified included: naming, prognosis, personal illness history, symptoms, and causality. Patients did not emphasize mortality. Responses varied by diagnosis and education but not illness severity. Subjects who completed high school more often referenced mortality and named their illness. Cancer patients' responses more often included prognosis while non-cancer patients referenced symptoms and causality. These differences were also reflected in reported discussions of their future with their physicians. Conclusion. Because most patients do not discuss their illness in terms of mortality but instead describe living with illness, these themes provide patient-centered guidance on using open-ended questions to explore patients' perceptions of illness earlier in the disease trajectory. Implications for research, policy, or practice. Our results require a shift from research emphasizing illness understanding as a dichotomous model of awareness of dying. Studies on patient- physician communication should incorporate these themes to develop techniques tailored to diagnosis and education level for partnering with patients earlier in the course of life-limiting illness.

Institution

(Morris) Durham VA Medical Center, Duke University, Durham, NC, United States (Johnson) Duke University, Durham, NC, United States

(Steinhauser) Duke and VA Medical Center, Durham, NC, United States

Correspondence Address

D. Morris, Durham VA Medical Center, Duke University, Durham, NC, United States

73

Publisher

Elsevier Inc.

Emtree Heading

*human; *general aspects of disease; *palliative therapy; *patient; *hospice; *nurse; cancer patient; physician; mortality; prognosis; interpersonal communication; diagnosis; education; epidemiology; neoplasm; high school; policy; longitudinal study; interview; advanced cancer; qualitative analysis; disease severity; model.

ISSN

0885-3924

DOI

http://dx.doi.org/10.1016/j.jpainsymman.2011.12.050

Language

English

Summary Language

English

Entry Week

201205

Date Delivered

20120124

Year of Publication

2012

Copyright

Copyright 2012 Elsevier B.V., All rights reserved.

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Advanced communication strategies for relationship-centered care.

Rider E.A.

Pediatric Annals. 40 (9) (pp 447-453), 2011. Date of Publication: September 2011.

[Journal: Article]

AN: 2012111966

Institution

(Rider) Institute for Professionalism and Ethical Practice, Children's Hospital Boston, United States (Rider) The John D. Stoeckle Center for Primary Care Innovation, Massachusetts General Hospital, United States

(Rider) Harvard Medical School, United States

Correspondence Address

E. A. Rider, Institute for Professionalism and Ethical Practice, Children's Hospital Boston, 1153 Centre St., Suite 31, Boston, MA 02130-3446, United States. E-mail: elizabeth_rider@hms.harvard.edu

Country of Publication

United States

Publisher

74

Slack Incorporated (6900 Grove Road, Thorofare NJ 08086-9447, United States)

URL

http://www.pediatricsupersite.com/showPdf.aspx?rid=87296

Emtree Heading

article; child health care; communication skill; developmental stage; emotional stress; empathy; family; health care personnel; health care quality; human; *interpersonal communication; malpractice; medical education; medical ethics; medical information system; medical practice; mental stress; nurturing behavior; outcome assessment; patient care; patient satisfaction; personality; primary medical care; professional development; professionalism.

Number of References

41

Embase Section Headings

Public Health, Social Medicine and Epidemiology [17], Health Policy, Economics and Management [36]

ISSN

0090-4481

DOI

http://dx.doi.org/10.3928/00904481-20110815-08

CODEN

PDANB

Language

English

Entry Week

201210

Date Delivered

20120305

Year of Publication

2011

Copyright

Copyright 2012 Elsevier B.V., All rights reserved.

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A new model for breaking bad news to people with intellectual disabilities.

Tuffrey-Wijne I.

Journal of Intellectual Disability Research. Conference: 14th World Congress of the International Association for the Scientific Study of Disabilities, IASSID 2012 Halifax, NS Canada. Conference Start: 20120709 Conference End: 20120714. Conference Publication: (var.pagings). 56 (7-8) (pp 702), 2012. Date of Publication: July 2012.

[Journal: Conference Abstract]

AN: 70808866

Aim: Current models for breaking bad news are inadequate in meeting the needs of people with intellectual disabilities (ID). They are often not told of a life-limiting diagnosis. The task

75

of breaking bad news is often left to carers who are poorly prepared and supported in this. Health care professionals do not know how to communicate adequately with people with ID. Methods: The model was developed following a focus group/ interview study involving 109 participants, including people with ID, family carers, ID professionals, and health care professionals. The findings were combined with the literature. A preliminary model was developed; 60 stakeholders gave feedback on the model, including a wide range of family carers, professionals and academics. The preliminary version of the model was modified following feedback. Results: The model has four components. (1) Building a foundation of knowledge. Gradually and over time, the person with learning disabilities builds his/her understanding of the way his/her situation is changing because of the bad news; (2) capacity and understanding; (3) the people involved; and (4) the support needed by everyone involved. The model will be visually presented. Conclusion: The model now needs to be tested in practice.

Institution

(Tuffrey-Wijne) St. George's Unviversity of London, United Kingdom

Correspondence Address

I. Tuffrey-Wijne, St. George's Unviversity of London, United Kingdom. E-mail: ituffrey@sgul.ac.uk

Publisher

Blackwell Publishing Ltd

Emtree Heading

*human; *intellectual impairment; *disability; *model; health care personnel; feedback system; learning disorder; non profit organization; interview; diagnosis.

ISSN

0964-2633

DOI

http://dx.doi.org/10.1111/j.1365-2788.2012.01583_5.x

Language

English

Summary Language

English

Entry Week

201230

Date Delivered

20120717

Year of Publication

2012

Copyright

Copyright 2012 Elsevier B.V., All rights reserved.

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A model for emergency department end-of-life communications after acute devastating events-part I: Decision-making capacity, surrogates, and advance directives.

Limehouse W.E., Ramana Feeser V., Bookman K.J., Derse A.

76

Academic Emergency Medicine. 19 (9) (pp 1068-1072), 2012. Date of Publication: September 2012.

[Journal: Conference Paper]

AN: 2012551819

Making decisions for a patient affected by sudden devastating illness or injury traumatizes a patient's family and loved ones. Even in the absence of an emergency, surrogates making end-of-life treatment decisions may experience negative emotional effects. Helping surrogates with these end-of-life decisions under emergent conditions requires the emergency physician (EP) to be clear, making medical recommendations with sensitivity. This model for emergency department (ED) end-of-life communications after acute devastating events comprises the following steps: 1) determine the patient's decision-making capacity; 2) identify the legal surrogate; 3) elicit patient values as expressed in completed advance directives; 4) determine patient/surrogate understanding of the life-limiting event and expectant treatment goals; 5) convey physician understanding of the event, including prognosis, treatment options, and recommendation; 6) share decisions regarding withdrawing or withholding of resuscitative efforts, using available resources and considering options for organ donation; and 7) revise treatment goals as needed. Emergency physicians should break bad news compassionately, yet sufficiently, so that surrogate and family understand both the gravity of the situation and the lack of long-term benefit of continued life-sustaining interventions. EPs should also help the surrogate and family understand that palliative care addresses comfort needs of the patient including adequate treatment for pain, dyspnea, or anxiety. Part I of this communications model reviews determination of decision-making capacity, surrogacy laws, and advance directives, including legal definitions and application of these steps; Part II (which will appear in a future issue of AEM) covers communication moving from resuscitative to end-of-life and palliative treatment. EPs should recognize acute devastating illness or injuries, when appropriate, as opportunities to initiate end-of-life discussions and to implement shared decisions. 2012 by the Society for Academic Emergency Medicine.

Institution

(Limehouse) Department of Medicine, Division of Emergency Medicine, Medical University of South Carolina, Charleston, SC, United States (Ramana Feeser) Department of Emergency Medicine, Virginia Commonwealth University Medical Center, Richmond, VA, United States

(Bookman) Department of Emergency Medicine, University of Colorado, Aurora, CO, United States

(Derse) Department of Emergency Medicine, Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, WI, United States

Correspondence Address

W.E. Limehouse, Department of Medicine, Division of Emergency Medicine, Medical University of South Carolina, Charleston, SC, United States. E-mail: wlimehouse@comcast.net

Country of Publication

United Kingdom

Publisher

Blackwell Publishing Ltd (9600 Garsington Road, Oxford OX4 2XG, United Kingdom)

Emtree Heading

anxiety; conference paper; dyspnea; emergency health service; emergency physician; *emergency ward; *end of life communication; family centered care; human; informed consent; interpersonal communication; law; living will; *medical decision making; medicolegal aspect; pain; palliative therapy; priority journal; prognosis; resuscitation; surrogacy law; *terminal care.

Number of References

25

77

Embase Section Headings

Public Health, Social Medicine and Epidemiology [17], Anesthesiology [24], Psychiatry [32], Forensic Science Abstracts [49]

ISSN

1069-6563

Electronic ISSN

1553-2712

DOI

http://dx.doi.org/10.1111/j.1553-2712.2012.01426.x

CODEN

AEMEF

Language

English

Summary Language

English, Spanish

Entry Week

201240

Date Delivered

20121001

Year of Publication

2012

Copyright

Copyright 2012 Elsevier B.V., All rights reserved.

Link to the Ovid Full Text or citation:

Click here for full text options

Google Scholar

From 1st 50 results…

Creating COMFORT: A communication-based model for breaking bad news

M Villagran, J Goldsmith… - Communication …, 2010 - Taylor & Francis This study builds upon existing protocols for breaking bad news (BBN), and offers an interaction-based approach to communicating comfort to patients and their families. The goal was to analyze medical students'(N= 21) videotaped standardized patient BBN ... Cited by 7 Related articlesLancashire Teaching HospitalsFind@The Christie All 2 versions

Breaking bad news education for emergency medicine residents: A novel training module using simulation with the SPIKES protocol

I Park, A Gupta, K Mandani, L Haubner… - Journal of Emergencies …, 2010 - ncbi.nlm.nih.gov Abstract Breaking bad news (BBN) in the emergency department (ED) is a common occurrence. This is especially true for an emergency physician (EP) as there is little time to prepare for the event and likely little or no knowledge of the patients or family background ... Cited by 6 Related articlesLancashire Teaching HospitalsFind@The Christie All 10 versions

78

Disclosing the truth to terminal cancer patients: a discussion of ethical and cultural issues

GA Kazdaglis, C Arnaoutoglou, D Karypidis… - …, 2010 - applications.emro.who.int ... Even though for many patients this person is their nurse, breaking bad news is not a common ... The me- dia constantly report complaints about the way patients have received bad news. Disclosing the truth by just giving clinical facts, without concern for the sensitivity with which it ... Cited by 12 Related articles View as HTML All 3 versions

What do we know about giving bad news? A review

ME Harrison, A Walling - Clinical pediatrics, 2010 - cpj.sagepub.com ... Acad Med. 2004;79:107-117. 6. Dosanjh S, Barnes J, Bhandari M. Barriers to breaking bad news among medical and surgical residents. Med Educ. 2001;35:197-205. ... 11. Ptacek JT, Eberhardt TL. Breaking bad news: a review of the literature. JAMA. 1996;276:496-502. 12. ... Cited by 10 Related articlesFind@The Christie All 4 versions

Communication training in oncology: results of intensive communication workshops for Italian oncologists

R Lenzi, WF Baile, A Costantini… - European journal of …, 2010 - Wiley Online Library ... No training in communication, 65%. In their practice, physicians frequently had to discuss aspects of breaking bad news with patients and family members. The most frequent bad news included telling patients that no cure was available and disclosing a cancer diagnosis. ... Cited by 6 Related articlesLancashire Teaching HospitalsFind@The Christie All 3 versions

Managing the delivery of bad news: An in-depth analysis of doctors' delivery style

J Shaw, S Dunn, P Heinrich - Patient Education and Counseling, 2012 - Elsevier ... Abstract. Objective. The purpose of this study was to identify and describe the delivery styles doctors typically use when breaking bad news (BBN). Methods. ... Breaking bad news: a primer for radiologists in breast imaging. J Am Coll Radiol, 4 (2007), pp. 800–808. ... Cited by 3 Related articlesLancashire Teaching HospitalsFind@The Christie All 3 versions

Educating the delivery of bad news in medicine: Preceptorship versus simulation

AP Jacques, EJ Adkins, S Knepel… - … Journal of Critical …, 2011 - ncbi.nlm.nih.gov ... Teaching breaking bad news using mixed reality simulation. J Surg Res. ... [PubMed]. 13. Park I, Gupta A, Mandani K, Haubner L, Peckler B. Breaking bad news education for emergency medicine residents: A novel training module using simulation with the SPIKES protocol. ... Cited by 2 Related articlesLancashire Teaching HospitalsFind@The Christie All 5 versions

Experiences and attitudes of patients with terminal cancer and their family caregivers toward the disclosure of terminal illness

YH Yun, YC Kwon, MK Lee, WJ Lee… - Journal of Clinical …, 2010 - jco.ascopubs.org ... We used univariate analysis to estimate the odds ratio (OR) for each independent variable. (The OR is the extent to which being a member of a specific group increased or decreased the probability of agreeing with the model of attitudes toward disclosing bad news.). ... Cited by 21 Related articlesLancashire Teaching HospitalsFind@The Christie All 4 versions

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