An Important Neglected Topic “Breaking Bad News”: What Do Physicians Know?

Abstract

Aim: Breaking bad news (BBN), which is defined as the delivering new medical information that negatively affects the patient’s life, is an important and difficult communication skill that physicians should improve skills. This study was conducted to evaluate the knowledge, attitudes and behaviors about BBN of resident physicians in a university hospital.

Materials and Methods: This descriptive study was conducted in a university hospital between 01.03.2022 and 01.04.2022. Data were collected through an online questionnaire consisting of 35 questions. Behaviors related to BBN communication were evaluated on a 5-point Likert-type scale as never, rarely, sometimes, often, always.

Results: The mean age of the 117 physicians participating in the study was 28.7±2.41 (min: 24-max: 38), 52.1% of them were male. 47.9% of the participants were married and 71.8% were working in internal medicine. It was found that 64.1% of the physicians had given bad news in the last 6 months. The BBN (78.8%) of physicians working in surgical departments was significantly higher than those working in internal departments (58.3%) (p=0.038). The rate of those who did not receive training on BBN was 85.5%, and the rate of those who wanted to receive training on BBN was 76.9%. The rate of those who heard about SPIKES and BREAKS protocols for BBN was 5.1%. Getting patient’s consent before BBN, not giving clear information to the patient about the prognosis of his disease and conveying the bad news only to the relatives of the patient were found to be behaviors that were usually /always done in 31.6%, 26.5% and 23.1% respectively. Usually/always empathizing during BBN communication was found to be significantly higher in physicians working in internal medicine (70.2%) than physicians working in surgical departments (45.5%) (p=0.012).

Conclusion: In conclusion, in our study, it was found that most of the physicians related to BBN did not receive training and were inadequate in some behaviors related to BBN communication. All physicians should be provided with training on BBN during their medical school education and after graduation, so that all physicians’ communication skills should be improved and bad news should be conveyed appropriately.