Breaking Bad News in the Emergency Department: How do the Patients Want it?

Güven, Ramazan; Kaykısız, Eylem Kuday; AKYÜZ, Hatice ÖNTÜRK; Şaşmaz, Muhammed İkbal; Arı, Asım; Eyüpoğlu, Gökhan; Parlak, Ayse Gurol

doi:10.5152/eajem.2018.27146

Cited by 2 publications

(4 citation statements)

References 13 publications

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“…[18][19][20][21] The ED, with its huge patient load and sometimes lack of space, is not the optimal setting to break bad news. 22 While an extent of care plan was quite readily documented in our sample of patients, they were mostly recorded as 'not for CPR/ICU/intubation' [cardiopulmonary resuscitation/intensive care unit]. It is not clear how the actual goals-ofcare discussions were carried out.…”

Section: Discussionmentioning

confidence: 96%

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A retrospective study on end-of-life care in the emergency department of a tertiary hospital in Singapore

Goh

Jaffar

et al. 2020

Proceedings of Singapore Healthcare

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Introduction: The emergency department receives a whole breadth of patient types. Those who are imminently dying may attend the emergency department in the hours or days leading up to their demise, necessitating the initiation of end-of-life care in the emergency department. Aim: The aim of our study was to describe the characteristics and management of imminently dying patients who had presented to our emergency department to identify opportunities for improvement in the provision of end-of-life care in the emergency department. Methods: A retrospective study involving patients who died in the emergency department within 48 hours of registration presenting between 1 January 2018 and 31 December 2018 was carried out. Results: Out of 59 included patients, 91.5% had pre-existing medical conditions; 25.4% had end-stage organ failure of which renal and cardiac were most common. Only 15.3% had preferred care plans documented and among these, only a minority (33.3%) had undergone formal advance care planning. The most common presenting symptom among patients who died within 48 hours was dyspnoea (44.1%). The most common investigation done was capillary blood glucose (84.7%) and the most common procedure was an intravenous peripheral cannula insertion (84.7%). Antibiotics were given in 30.5% of the patients and fentanyl was administered in 20.3% for symptom control. Conclusion: The majority of patients presenting to the emergency department within hours or days of their demise had pre-existing chronic or terminal conditions but only a few had specified their preferences for end-of-life care. Investigations and procedures that do not affect patient comfort or outcomes should be minimised.

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Section: Discussionmentioning

confidence: 96%

“…18–21 The ED, with its huge patient load and sometimes lack of space, is not the optimal setting to break bad news. 22…”

Section: Discussionmentioning

confidence: 99%

A retrospective study on end-of-life care in the emergency department of a tertiary hospital in Singapore

Goh

Jaffar

et al. 2020

Proceedings of Singapore Healthcare

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“…Hence, providing healthcare is, at its essence, a communication process and healthcare workers are the professional side of this process. In a doctor-patient relationship, the expectation of patients from doctors, in terms of communication, is to establish a bilateral relationship based on honest, simple, and clear language that makes patients feel understood [3,[16][17][18]. This is also an expectation of effective communication.…”

Section: Discussionmentioning

confidence: 99%

“…Breaking bad news to patients is also a complex and multidimensional issue process for physicians. As part of the medical practice in some societies, hiding bad news from the patient or sharing the seriousness of the illness with the patient relatives rather than directly with the patient is not an uncommon practice [18]. Such an approach also means that this process involves a separate challenge for physicians in terms of medical practice.…”

Section: Discussionmentioning

confidence: 99%

Breaking bad news: patients’ perspectives of the information process in a general surgery outpatient clinic survey

Ondes¹,

Erbay²

2022

Med-Science

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The aim of this study is to investigate the perspectives of the patients admitted to a general surgery outpatient clinic towards the processes of being informed and receiving bad news. A questionnaire developed by the authors was provided to 319 patients. The scoring of some statements was based on a 5-item Likert scale, while other statement scoring was based on an 11-item Likert scale. Of all, 74.1% of the participants stated that “the doctor’s way of communicating information to them” is absolutely important, while 49.2% stated that “to whom the physician will communicate a bad news /malignant illness about oneself” is also of absolute importance. In case of a malignant illness, statements emphasizing that only the patient is to be notified have been adopted more commonly. Single participants stated it was more important to be personally notified first, rather than their relatives. The long-held idea that the patient may be affected by bad news and disrupt his/her treatment is no longer a consideration by patients. Even if their relatives are involved in the process in the later stages of the disease, the patients wish to hear the news first themselves.

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Breaking Bad News in the Emergency Department: How do the Patients Want it?

Cited by 2 publications

References 13 publications

A retrospective study on end-of-life care in the emergency department of a tertiary hospital in Singapore

A retrospective study on end-of-life care in the emergency department of a tertiary hospital in Singapore

Breaking bad news: patients’ perspectives of the information process in a general surgery outpatient clinic survey

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