How to Break Bad News: Physicians’ and Nurses’ Attitudes

  • Mohammad Arbabi Mail Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran Psychiatry and Psychology research center, Tehran University of Medical Science, Tehran, Iran Psychosomatic ward, Imam Khomeini Hospital, Tehran,Iran
  • Ava Roozdar Psychiatry and Psychology research center, Tehran University of Medical Science, Tehran, Iran
  • Mohammad Taher Psychiatry and Psychology research center, Tehran University of Medical Science, Tehran, Iran
  • Samira Shirzad Psychiatry and Psychology research center, Tehran University of Medical Science, Tehran, Iran
  • Mohsen Arjmand Psychiatrist, Center for Brain, Cognition and Culture Studies, Tehran, Iran
  • Mohammad Reza Mohammadi Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran Psychiatry and Psychology research center, Tehran University of Medical Science, Tehran, Iran
  • Ali-Akbar Nejatisafa Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran Psychiatry and Psychology research center, Tehran University of Medical Science, Tehran, Iran Psychosomatic ward, Imam Khomeini Hospital, Tehran,Iran Psychiatrist, Center for Brain, Cognition and Culture Studies, Tehran, Iran
  • Mamak Tahmasebi Inistitute of Cancer, Tehran University of Medical Sciences, Tehran, Iran
  • Alale Roozdar Psychiatry and Psychology research center, Tehran University of Medical Science, Tehran, Iran
Keywords:
Communication, Physician-patient relationship, Truth disclosures

Abstract

Objective: Bad news disclosure is one of the most complex tasks of physicians. Recent evidences indicate that patients' and physicians' attitude toward breaking bad news has been changed since few years ago. The evidence of breaking bad news is different across cultures. The aim of this study is to evaluate the attitude of medical staff toward breaking bad news to provide a clinical guideline in Iran.
Methods:
A descriptive study was conducted during 2008-2009 on a sample of 100 medical staff (50 physicians and 50 nurses) at Cancer Institute of Imam Khomeini hospital. The subjects' demographic characteristics and their attitudes toward the manner of revealing the diagnosis were registered in a questionnaire.
Results: The majority of the physicians (86%, n=43) and nurses (74%, n=37), mostly the older and more experienced, tended to reveal the diagnosis to patients. Only a few physicians (8%, n=4) had been trained how to disclose bad news, which discloused diagnosis more than non trained ones. Physicians and nurses preferred to inform the patients about the diagnosis when either the patients were alone or in the presence of their spouse respectively. Only a few physicians (14%) and nurses (24%) agreed to explain life expectancy to patients.
Conclusion:
Compared to past, physicians and nurses are more willing to share cancer diagnosis with patients. However, lack of adequate communication skills in caregivers, and their concerns about managing patients' emotional reactions reduce their tendency to disclose bad news to the patients. Therefore, training physicians and nurses to expose bad news to the patients seems to be necessary.

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How to Cite
1.
Arbabi M, Roozdar A, Taher M, Shirzad S, Arjmand M, Mohammadi MR, Nejatisafa A-A, Tahmasebi M, Roozdar A. How to Break Bad News: Physicians’ and Nurses’ Attitudes. Iran J Psychiatry. 5(4):128-133.
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