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

机译:如何打破坏消息:医生和护士的态度

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ObjectiveBad 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.MethodsA 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.ResultsThe 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.ConclusionCompared 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.
机译:ObjectiveBad新闻披露是医师最复杂的任务之一。最近的证据表明,自几年前以来,患者和医生对突发坏消息的态度已经改变。打破坏消息的证据因文化而异。这项研究的目的是评估伊朗医务人员对突发新闻的态度以提供伊朗临床指南。方法2008-2009年期间对癌症100名医务人员(50名医生和50名护士)进行了描述性研究伊玛目霍梅尼医院研究所。在问卷中记录了受试者的人口统计学特征及其对揭示诊断方式的态度。结果大多数医生(86%,n = 43)和护士(74%,n = 37),大多数年龄较大,且更多经验丰富,倾向于向患者揭示诊断。只有少数医生(8%,n = 4)受过如何披露坏消息的培训,比未受过培训的医生更能泄露诊断信息。医生和护士更愿意在患者独自一人或在医院内时告知患者有关诊断的信息。他们的配偶分别在场。只有少数医生(14%)和护士(24%)同意向患者解释预期寿命。结论与过去相比,医生和护士更愿意与患者分享癌症诊断信息。但是,护理人员缺乏足够的沟通技巧,以及他们对管理患者情绪反应的担忧降低了他们向患者披露坏消息的趋势。因此,培训医师和护士向患者暴露坏消息似乎是必要的。

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