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Breaking bad news

I Bragard, M Guillaume, A Ghuysen, J C Servotte, I Ortiz, B Pétré
The transformations of the health system and the preferences of the patients themselves have led healthcare professionals to rethink the place and role of the patient in the healthcare system, putting the caregivercare relationship and communication at the heart of public health issues. The literature shows that empathic communication is associated with better adherence to treatment, better patient satisfaction and less litigation. However, the initial training programs of health professionals are little oriented towards this field...
February 2018: Revue Médicale de Liège
Felix Michael Schmitz, Kai Philipp Schnabel, Daniel Bauer, Cadja Bachmann, Ulrich Woermann, Sissel Guttormsen
OBJECTIVES: Effective instructional approaches are needed to enable undergraduates to optimally prepare for the limited training time they receive with simulated patients (SPs). This study examines the learning effects of different presentation formats of a worked example on student SP communication. METHODS: Sixty-seven fourth-year medical students attending a mandatory communication course participated in this randomized field trial. Prior to the course, they worked through an e-learning module that introduced the SPIKES protocol for delivering bad news to patients...
February 24, 2018: Patient Education and Counseling
Jennifer N Stojan, Eleanor Y Sun, Arno K Kumagai
PURPOSE: Educational approaches involving patient stories aim at enhancing empathy and patient-centered care; however, it is not known whether the influence of such programs on physician attitudes persists beyond medical school. MATERIALS AND METHODS: The Family Centered Experience (FCE) paired preclinical medical students with patient families over two years and engaged students in reflective dialogs about the volunteers' stories. This study examined possible long-term influences on attitudes toward medicine and doctoring...
February 28, 2018: Medical Teacher
Afsaneh Yakhforoshha, Seyed Amir Hossein Emami, Farhad Shahi, Saeed Shahsavari, Mohammadali Cheraghi, Rita Mojtahedzadeh, Behrooz Mahmoodi-Bakhtiari, Mandana Shirazi
The task of breaking bad news (BBN) may be improved by incorporating simulation with art-based teaching methods. The aim of the present study was to assess the effect of an integrating simulation with art-based teaching strategies, on fellows' performance regarding BBN, in Iran. The study was carried out using quasi-experimental methods, interrupted time series. The participants were selected from medical oncology fellows at two teaching hospitals of Tehran University of Medical Sciences (TUMS), Iran. Participants were trained through workshop, followed by engaging participants with different types of art-based teaching methods...
February 21, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
Sushma Bhatnagar, Anuradha Patel
Background: Palliative medicine is an upcoming new specialty aimed at relieving suffering, improving quality of life and comfort care. There are many challenges and barriers in providing palliative care to our patients. The major challenge is lack of knowledge, attitude and skills among health-care providers. Objectives: Evaluate the effectiveness of the certificate course in essentials of palliative care (CCEPC) program on the knowledge in palliative care among the participants...
January 2018: Indian Journal of Palliative Care
Paweł Marschollek, Katarzyna Bąkowska, Wojciech Bąkowski, Karol Marschollek, Radosław Tarkowski
The way that bad news is disclosed to a cancer patient has a crucial impact on physician-patient cooperation and trust. Consensus-based guidelines provide widely accepted tools for disclosing unfavorable information. In oncology, the most popular one is called the SPIKES protocol. A 17-question survey was administered to a group of 226 patients with cancer (mean age 59.6 years) in order to determine a level of SPIKES implementation during first cancer disclosure. In our assessment, the patients felt that the highest compliance with the SPIKES protocol was with Setting up (70...
February 5, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
Amulya A Nageswara Rao, Deepti M Warad, Amy L Weaver, Cathy D Schleck, Vilmarie Rodriguez
Pediatric hematologists/oncologists face complex situations such as breaking bad news, treatment/clinical trials discussions, and end-of-life/hospice care. With increasing diversity in patient and physician populations, cultural competency and sensitivity training covering different aspects of pediatric hematology/oncology (PDHO) care can help improve health care delivery and reduce disparities. Though it is considered a required component of fellowship training, there is no clearly defined curriculum meant specifically for PDHO fellows-in-training (PDHO-F)...
January 27, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
José Atienza-Carrasco, Manuel Linares-Abad, María Padilla-Ruiz, Isabel María Morales-Gil
No abstract text is available yet for this article.
January 23, 2018: Reproductive Health
Maria Silvia Vellutini Setubal, Maria Ângela Reis Goes Monteiro Antonio, Eliana Martorano Amaral, John Boulet
OBJECTIVE:  Breaking bad news (BBN) is particularly difficult in perinatology. Previous research has shown that BBN skills can be learned and improved when taught and practiced. This project evaluated whether a structured training session would enhance perinatology residents' skills in BBN. METHODS:  This was a randomized controlled intervention study with year 1 to 4 Perinatology residents from a medical school in Brazil, during the 2014/15 school year. A total of 61 out of 100 (61%) eligible residents volunteered to a structured training program involving communicating a perinatal loss to a simulated patient (SP) portraying the mother followed by the SP's immediate feedback, both video recorded...
January 17, 2018: Revista Brasileira de Ginecologia e Obstetrícia
James Downar
This article presents a rapid review of the published literature and available resources for educating Canadian physicians to provide palliative and end-of-life care. Several key messages emerge from the review. First, there are many palliative care educational resources already available for Canadian physicians. Second, the many palliative care education resources are often not used in physician training. Third, we know that some palliative care educational interventions are inexpensive and scalable, while others are costly and time-consuming; we know very little about which palliative care educational interventions impact physician behavior and patient care...
January 2018: Journal of Palliative Medicine
Alexandre Berney, Céline Bourquin
This article reports on what is at work during individual supervision of medical students in the context of teaching breaking bad news (BBN). Surprisingly, there is a relative lack of research and report on the topic of supervision, even though it is regularly used in medical training. Building on our research and teaching experience on BBN at the undergraduate level, as well as interviews of supervisors, the following key elements have been identified: learning objectives (e.g., raising student awareness of structural elements of the interview, emotion (patients and students) handling), pedagogical approach (being centered on student's needs and supportive to promote already existing competences), essentials (e...
December 22, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
Rinat Gold, Azgad Gold
Purpose: The purpose of this study was to examine the attitudes, feelings, and practice characteristics of speech-language pathologists (SLPs) in Israel regarding the subject of delivering bad news. Method: One hundred and seventy-three Israeli SLPs answered an online survey. Respondents represented SLPs in Israel in all stages of vocational experience, with varying academic degrees, from a variety of employment settings. The survey addressed emotions involved in the process of delivering bad news, training on this subject, and background information of the respondents...
December 13, 2017: American Journal of Speech-language Pathology
Edgar Landa-Ramírez, Antonio López-Gómez, Irma Jiménez-Escobar, Juan José Sánchez-Sosaa Sánchez-Sosaa
The aim of this paper is to describe educational programs that reportedly teach how to break bad news in the emergency department. We also suggest some recommendations on how to communicate bad news based on the research of evidence available in the field. The examined evidence points toward six major components with which physicians should familiarize when communicating bad news: 1) doctor-patient empathic communication, 2) establishing a proper space to give the news, 3) identifying characteristics of the person who receives the news, 4) essential aspects for communicating the news; 5) emotional support, and 6) medical and administrative aspects of the encounter...
November 2017: Revista Médica del Instituto Mexicano del Seguro Social
Shalini Dalal, Jessica A Moore, Colleen M Gallagher
Patients and their families have identified the need for ongoing and effective communication as one of the important aspects of medical care, especially when the cessation of disease-modifying therapies is being considered at the end-of-life (EOL). Despite recognizing that this communication is extremely important, clinicians are uneasy and find themselves inadequately trained to "break bad news" and manage emotional responses from the patient/family. The inherent difficulties in accurately predicting prognosis and discussing potential complications make these conversations even more challenging...
2017: Narrative Inquiry in Bioethics
Ali Karimi Rozveh, Reza Nabi Amjad, Javad Karimi Rozveh, Davood Rasouli
Background:Patients generally have the right to be informed of their condition, but the debate over the issue of truth disclosure is still present. The attempt of this study is to review the approaches toward truth- telling to cancer patients in Iran. Materials and Methods: This study is a narrative review that included articles published in Iran on attitudes toward telling the truth to cancer patients. The present study extracted data from articles published in PubMed, Science Direct, Scientific Information Database (SID), Magiran, Iran Medex, Google Scholar, Iranian Research Institute for Information Science and Technology with key terms such as truth disclosure, breaking bad news, death awareness and disclosure of diagnosis without any time restriction...
July 1, 2017: International Journal of Hematology-oncology and Stem Cell Research
Cassiana Mendes Bertoncello Fontes, Daniele Vieira de Menezes, Maria Helena Borgato, Marcos Roberto Luiz
Objectives: describe how the process of breaking bad news is established and identify how nurses approach the task of giving bad news. Method: integrative review of the literature for articles in Portuguese and English published between 1993-2014, in the databases: Bireme, PubMed, Scopus, Web of Science, CINAHL and Embase. Nine articles were included using the selection flow chart. A digital form was completed for each article according to the Consolidated Criteria for Reporting Qualitative Research checklist and the level of scientific evidence was determined...
September 2017: Revista Brasileira de Enfermagem
Meridith Bumb, Joanna Keefe, Lindsay Miller, Janine Overcash
BACKGROUND: A diagnosis of cancer is a stressful, difficult, and life-altering event. Breaking bad news is distressing to patients and families and is often uncomfortable for the nurse delivering it. Evidence-based communication models have been developed and adapted for use in clinical practice to assist nurses with breaking bad news.

. OBJECTIVES: The purpose of this article is to provide an overview on breaking bad news and to review the utility of the SPIKES and PEWTER evidence-based communication models for oncology nurses...
October 1, 2017: Clinical Journal of Oncology Nursing
Tim J Hartung, David Kissane, Anja Mehnert
Medical communication is a skill which can be learned and taught and which can substantially improve treatment outcomes, especially if patients' communication preferences are taken into account. Here, we give an overview of communication training research and outline the COMSKIL program as a state-of-the-art communication skills training in oncology. COMSKIL has a solid theoretical foundation and teaches core elements of medical communication in up to ten fully operationalized modules. These address typical situations ranging from breaking bad news to responding to difficult emotions, shared decision-making, and communicating via interpreters...
2018: Recent Results in Cancer Research
Keith M Swetz
Words matter. They have tremendous power to heal or hurt. And although the patients we care for in oncology and palliative medicine often die from, or despite, their neoplastic illness; caregivers and loved ones often hold onto the words that clinicians share with them during their times of struggle and grief. In this narrative, the author (as first person) reflects on some systemic challenges he faced in dealing with illness and loss when his father battled two distinct neoplastic processes. He explores the commonalities and differences that he experienced as a palliative care physician, and how that has guided his medical practice moving forward...
June 23, 2017: Annals of Palliative Medicine
E Grace Lewis, Lloyd L Oates, Jane Rogathi, Ashanti Duinmaijer, Aisa Shayo, Simon Megiroo, Barthlomew Bakari, Felicity Dewhurst, Richard W Walker, Matt Dewhurst, Sarah Urasa
OBJECTIVE: Little is known about the current views and practices of healthcare professionals (HCPs) in Sub-Saharan Africa (SSA) regarding delivery of hospital palliative care. The present qualitative study explored the views of nursing staff and medical professionals on providing palliative and end-of-life care (EoLC) to hospital inpatients in Tanzania. METHOD: Focus group discussions were conducted with a purposive sample of HCPs working on the medical and pediatric wards of the Kilimanjaro Christian Medical Centre, a tertiary referral hospital in northern Tanzania...
August 22, 2017: Palliative & Supportive Care
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