PurposeThe aim of our research was to gain knowledge about patients’ opinions, experiences, and preferences with regard to the way the news is being delivered to them.Materials and methodsDetailed research was carried out on a group of 314 patients using the CAWI (Computer-Assisted Web Interview) technique. Adult responders who had earlier received bad news were questioned about their opinion about the way the doctor acted while delivering bad news and how he did it.ResultsPatients, who define the following aspects of their visit as negative/lacking: 1) doctor’s behavior in the moment of delivering bad news, 2) amount of time devoted to the visit, 3) lack of doctor’s attention, 4) usage of medical terminology, 5) doctor’s honesty, 6) emotional and cognitive support from the doctor, more often tend to change the doctor in charge of their therapy or decide to cease the medical treatment.ConclusionDoctors’ behavior and the way they deliver news to patients are key elements that strongly influence patients’ future therapy. It makes an impact on patient’s decision whether to continue or cease the treatment. In the first case, it also leads the patient to choose to continue the treatment under the guidance of the same specialist or to find another one. The data that we acquired and that we will discuss below will form the basis for editing a communication protocol concerning delivering bad news. It is necessary to create such a protocol in order to improve the quality of communication with patients, especially as regards delivering bad news to them.
Background Empathy is an important competence in the professional development of medical students. The purpose of our study was to compare the levels and scales of empathy in people studying in different educational strategies. Methods The study was conducted between April 2019 and March 2020. Medicine, nursing, midwifery, physiotherapy, psychology, pedagogy and sociology students were the participants of this study. University students preparing for medical professions (n = 1001) and students of programs unrelated to medicine (n = 700) underwent the Empathy Quotient test (EQ-40). We have compared results in both study groups with the use of the distribution of density, analysis of variance and student’s t-test. Results The average results received by students of the university preparing for medical professions were lower (M = 42.6) than those of the non-medical university students (M = 45.3) and the differences between the universities turned out to be statistically important (t = − 5.15, df = 1699, p < 0.001). As many as 14.6% of the students in the 1st EQ class were preparing for various medical professions while 9% studied social sciences. 18.2% of all medical programme students (n = 412) manifested the lowest empathy class. Our research has revealed that the students with Asperger profile (AP) and high-functioning autism (HFA) studied at universities preparing for medical professions (n = 18) more frequently than at non-medical universities (n = 5). Conclusions We have noticed a serious indicator of erosion in the levels of empathy in medical students and an increase in the number of people with AP and HFA. Empathy decreases in students after the third year of their studies, regardless of the kind of university. We recommend an introduction of career counselling when specialization is being chosen.
Background: Numerous reports indicate the educational deficiencies of medical students in delivering bad-news-related skills. Evaluation of the performance of training programs in this area should be one of the key components of the educational process. The purpose of this study was to analyze medical students’ preferences and educational needs regarding DBN (delivering bad news). The effect of clinical experience on the self-assessment of skills was analyzed. Methods: The quantitative survey was conducted using the CAWI technique. The study involved 321 fifth- and sixth-year medical students from 14 medical universities in Poland. Pearson’s χ2 test was used for statistical analysis. The profile of respondents for categorical variables was determined by KMeans analysis. Results: As many as 75.1% of students revealed that they did not feel sufficiently prepared for DBN. Only 18.7% reported having adequate competence in this area. More than half of the inquired students (63.6%) witnessed a situation during their clinical practice in which a physician provided a patient with information about an unfavorable diagnosis. These students were less likely to declare that they could not deliver BN (43.4%) than students who had no such experience (58.2%). As many as 86.3% of the respondents reported the need for more time in DBN skills training. Students mostly preferred active teaching methods. Conclusions: Understanding students’ learning needs and preferences can help medical schools optimize their education programs to develop DBN-related competencies.
Introduction. Disclosing unfavorable information is a very important moment in both diagnostic and therapeutic processes. It is also a highly stress‑inducing factor, both among patients and physicians. During our research we tried to establish how exactly bad news is communicated to patients and the amount of stress that Polish physicians are under in such situations.Material and Methods. Quantitative research was conducted in a university clinical hospital. With the use of an anonymous questionnaire, physicians (n = 100) from oncology, internal diseases, cardiac surgery, gynecology, obstetrics, and urology clinics were asked about the sources and the intensity of stress involved in BBN (Breaking Bad News). Similarly, patients (n = 378) of said clinics were asked to evaluate the relationships they had with their doctors. Results. Most (66.7%) clinicians declared they always conveyed unfavorable information to their patients fully and in detail. Exactly 50.0% admitted they were experiencing high or very high level of stress while doing so. They were mostly (56.1%) anxious about depriving their patients of hope and (38.5%) feared they were letting their patients down. 37.3% of clinicians were afraid of emotional response. Significantly fewer physicians (43%) than patients (84.6%) were of the opinion that all of the medical orders must be followed to the letter.Conclusions. Results suggest that BBN was a stressful experience for physicians. It was mostly related to the fear of disrupting the patient's well‑being. Low level of effective communication was caused by the insufficiency of BBN skills. Social and cultural aspects also played a role.
Purpose: Many studies show that discriminatory practices are common in healthcare institutions, also in the form of medical staff's inappropriate behaviour. Weight stigma may not only become a source of unpleasant experience for the patients but also cause them to withdraw from the treatment, which may further exacerbate their condition. Patients and Methods: In a nationwide study, we asked 184 medical professionals, about their experiences and opinions on the discrimination of patients with obesity. The study was conducted in 2020, with the use of CAWI method, based on an original survey created for this study. Results: Most of the medical professionals (68.5%) estimated that the problem of worse attitudes towards patients suffering from obesity is a common phenomenon. About 48.4% witnessed medical staff's discriminatory behaviours. The most frequent forms of inappropriate behaviours pertained to interpersonal relations -mocking the appearance (96.6%), looks of disgust and repulsion (96.2%), lack of reaction to offensive remarks (92.0%) or scaring a patient with the necessity to lose weight (57.7%). The participants of the study pointed to limited access to dedicated medical equipment (62.4%) as a discriminatory systemic limitation. Conclusion: Discrimination of patients with obesity is a social issue, which also occurs within the health care system. Limited access to medical resources, gaps in knowledge of obesity and an insufficient level of soft skills in health care professionals are the key deficiencies, which hinder effective treatment.
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