Instruments for assessing health professionals' skills in breaking bad news: protocol for a systematic review of measurement properties

Strategies used to deliver bad news to the family of unexpected and sudden death victims: a scoping review protocol

OBJECTIVE

This scoping review aims to map the strategies used during the communication of bad news to families of unexpected and sudden death victims from the perspective of those receiving the news.

INTRODUCTION

The strategies used in communicating a person's death to their family, especially in unexpected and sudden situations, can have a profound impact on the grief management process. This communication is often carried out by a health professional (doctor, nurse, or paramedic), but may also be carried out by a police officer, depending on the context in which the situation has occurred (in or out of hospital).

INCLUSION CRITERIA

This scoping review will include studies on families of victims of unexpected and sudden death. All studies focusing on the strategies used to communicate bad news of unexpected and sudden death face to face, implemented by any professional in an intra-hospital or extra-hospital context, from the perspective of those who received the news, will be considered.

METHODS

This review will follow the JBI methodology for scoping reviews. An initial search will be conducted, followed by a second search for published and unpublished studies in major health-related electronic databases. Studies published in English, Spanish, French, and Portuguese will be included, with no geographical, cultural, or time limits. Data selection, extraction, and synthesis will be performed independently by 2 reviewers and will include details of populations, study methods, and strategies used. A narrative synthesis will accompany the results and describe how they relate to the objectives of the review.

REVIEW REGISTRATION

Open Science Framework https://osf.io/4rhw3.

Communication strategies used by medical physicians when delivering bad news at the Maputo Central Hospital, Mozambique: a cross-sectional study

BACKGROUND

Physicians' communication with patients and their families is important during both the disease diagnosis and prognosis stages and through the follow-up process. Effective physician communication improves patients' quality of life and satisfaction with care and helps reduce suffering for those newly diagnosed with advanced progressive illnesses. This study aims to identify the communication strategies physicians use in the transition to palliative care and how these professionals perceive their academic and clinical preparation concerning this task.

METHODS

A cross-sectional and quantitative study. Physicians providing palliative care at the Maputo Central Hospital, Mozambique, were invited to complete a 17-question questionnaire. This questionnaire was based on a Brazilian adaptation of the Setting-Perception-Invitation-Knowledge-Emotions-Strategy (SPIKES) tool, the P-A-C-I-E-N-T-E protocol, with additional questions regarding socio-demographic details and the integration of "communication of bad news" into hospital training.

RESULTS

Of the 121 participants, 62 (51.2%) were male, and 110 (90.9%) were general practitioners, with a median age of 36 years old. They had worked in clinical practice for a median of 8 years and in their current department for three years. The majority of the participants considered that they have an acceptable or good level of bad news communication skills and believed that they do it in a clear and empathic way, paying attention to the patient's requests and doubts; however, most were not aware of the existing tools to assist them in this task and suggested that delivering bad news ought to be integrated into the undergraduate medical course and included in hospital training.

CONCLUSIONS

This study adds to our understanding of physicians' strategies when communicating bad news in the context of palliative care at one Mozambique hospital. As palliative care is not fully implemented in Mozambique, it is important to use protocols suitable to the country's healthcare level to improve how doctors deal with patients and their family members.