Breaking Bad News A difficult but fundamentally important task for all health care professionals Physicians feel uncertain & uncomfortable while breaking bad news, leading to being distant & disengaged from their patients. Breaking Bad News Recent studies have shown that: Patients generally (50-90%) desire full & frank disclosure, though a sizeable minority still may not want the full disclosure.
Psychosocial Context Patients response is influenced by previous experiences & current social circumstances--- inappropriate timing Even simple diagnosis being incompatible with ones profession---tremors in cardiac surgeon. Family's perspective Family members prefer: privacy Good attitude of the person who gives the bad news Clarity of message Competency of physicians Time for questions Jurkovich GJ, et al. Deal with patient and family reactions Assess & respond to emotional reactions Be aware of cognitive coping (denial, blame, guilt, disbelief, acceptance, intellectualization) Allow for shut down, when patient turns off & stops listening Be empathetic; it is appropriate to say Im sorry or I dont know. Quotation The greatest revolution of our generation is the discovery that human beings, by changing the inner attitudes of their minds, can change the outer aspects of their lives. SCENARIO Tariq, a 55-year-old chain smoker taxi driver with persistent cough for 3 months, attends your clinic to find out the biopsy report of a lesion shown on a chest x-ray and CT scan. Scenario No 2 A 54-year-old lady attends your clinic to find out the result of an MRI of her spine.


BREAKING BAD NEWS Saleh al-zahrany Rajab al-zahrany Khalaf al-amery Mohareb al-reshedy Abdul-rahman al-serhani Abdul-rahman al-howiti.
Abdullah aldughaither, ziad thekry and abdulrahman abaalkhail B r e a k i n g B a d N e w s. COMMUNICATION: Disclosure And Discussion During Family Meeting And MDT Conference Maria Fidelis Manalo, MD, MSc Palliative Care. COMMUNICATION SKILLS IN MEDICINE ABDELAZIZ ELAMIN, MD, PhD, FRCPCH Professor of Child Health Sultan Qaboos University Muscat, Oman. The Art of Breaking Bad News Breaking Bad News Why is breaking bad news an important issue for doctors? Adolescent HIV Care and Treatment Module 4: Communicating with and Counseling Adolescents 1. Breaking Bad News Mary Ellen Foti, MD Revised August 11, 2003 Hercules fights the angel of death. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.


Varying needs of patient & family---patient wishes to know more himself & less information to pass on to family, family wishes vice versa.
Introduce yourself Acknowledge the persons anger Try to find out the reason for his anger, e.g. New York: Wiley, 1982 ) Focused training in communication skills & techniques to facilitate breaking of bad news has been demonstrated to improve patients satisfaction & physicians comfort. Med 1999) described:Clinicians focus often on relieving patients bodily pain, less often on their emotional distress & seldom on their suffering. Her report shows that she has secondaries all over her spine Proceed with this consultation.



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