Breaking bad news: can we get it right?

Breaking bad news to children with chronic kidney disease: A questionnaire-based study and literature review

Introduction

Breaking bad ne ws to caregivers of children with (CKD) [I can't comment in the box] Title says to breaking bad news to children but in here, breaking bad news to caregivers. Please clarify and edit accordingly. is an important role of nephrologists. In our practice there has been a thought about parental dissatisfaction from breaking bad news to CKD patients. Caregiver's preferences on how to be told the bad news in CKD children has not been studied adequately. Our objective was to identify how much is the emotional and knowledge satisfaction of CKD caregivers and the relation of their socioeconomic and educational levels with their preferences in breaking bad news.

Methods

A questionnaire based study was conducted for caregivers of CKD children, in the outpatient clinics, and peritoneal dialysis and hemodialysis units at the King Faisal Specialist Hospital and Research Centre for three months.

Results

83 questionnaires from caregivers of CKD patients age (1-14) years, mean age of 8.5 ± 3.9 years. (47.6%) were emotionally very satisfied, 29.5% were very satisfied about the knowledge they had.

Conclusion

Caregivers of CKD patients are satisfied emotionally more than the satisfaction about the amount of information they got. Different demographic data might affect their preferences in the way of receiving the bad news. The dissatisfaction suggesting that physicians' communication skills needs improvement.

Evaluation of physicians' skills in breaking bad news to cancer patients

Background:

Delivering bad news to patients is one of the most difficult tasks of physicians that play a big role in the process of treatment and cooperation of patients. The objective of this study is to evaluate the ability and skills of physicians in delivery bad news to cancer patients.

Methods:

This study is a cross-sectional study performed on 70 specialist physicians in two hospitals of Mashhad in 2016. Data were collected by Persian questionnaire of SPIKES included 16 questions and were analyzed by SPSS software.

Results:

In this study, among the questionnaire items, the most prevalent item was not giving the bad news by phone (100%) and the least prevalent item was putting the hand on the shoulder (24.3%). This study showed that 81.4% of doctors agreed on giving the bad news in private, 72.9% agreed on giving relative hope to patients and 67.1% agreed on evaluating patients knowledge of his/her disease when giving bad news.

Conclusion:

The results of this study show that the ability of physicians in giving bad news is not enough in some aspects. Therefore, holding educational courses during physicians’ education and after graduation are recommended to increase patients’ trust and decreasing worries and inconvenience of physicians in difficult situations of delivering bad news.