L’annonce de mauvaises nouvelles en oncologie : l’expérience belge

Delevallez, France; Liénard, Aurore; Gibon, Anne-Sophie; Razavi, Darius

doi:10.1016/j.rmr.2014.07.003

Cited by 8 publications

(7 citation statements)

References 24 publications

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“…1 One reason is that information is sometimes viewed as harmful to patients and the values of truthfulness and beneficence as in tension with each other ( 50 ). Moreover, this contrast serves to remind professionals that a patient who has been given bad news will need to be cared for in order to help him or her deal with a difficult situation ( 9 , 10 ). In contrast, our findings suggest that caring for the patient's emotions is also a component of truth-telling: unless he or she is in a position to understand and integrate the disclosed information, simple disclosure of true information will not be sufficient for truthfulness.…”

Section: Discussionmentioning

confidence: 99%

“…In the context of breaking bad news, however, truth-telling is also a distressing, difficult ( 6 ), and in rare cases even a dangerous task, which can go devastatingly wrong if conducted with insufficient skill or care ( 7 ). Breaking bad news is not only about truth-telling: it must also incorporate elements such as how to manage patient emotions, how to use the adequate communication skills, and how to anticipate consequences of the disclosed information on the patient and his or her family members ( 8 , 9 ). A recent metasynthesis identified that physicians in a situation of breaking bad news need to adapt to various factors related to the micro-system and the macro-system: their relationship to the patient, the patient's family, the institutional context, and the cultural milieu ( 10 ).…”

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confidence: 99%

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Helping medical students to acquire a deeper understanding of truth-telling

Hurst

Baroffio

Ummel

et al. 2015

Medical Education Online

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ProblemTruth-telling is an important component of respect for patients’ self-determination, but in the context of breaking bad news, it is also a distressing and difficult task.InterventionWe investigated the long-term influence of a simulated patient-based teaching intervention, integrating learning objectives in communication skills and ethics into students’ attitudes and concerns regarding truth-telling. We followed two cohorts of medical students from the preclinical third year to their clinical rotations (fifth year). Open-ended responses were analysed to explore medical students’ reported difficulties in breaking bad news.ContextThis intervention was implemented during the last preclinical year of a problem-based medical curriculum, in collaboration between the doctor–patient communication and ethics programs.OutcomeOver time, concerns such as empathy and truthfulness shifted from a personal to a relational focus. Whereas ‘truthfulness’ was a concern for the content of the message, ‘truth-telling’ included concerns on how information was communicated and how realistically it was received. Truth-telling required empathy, adaptation to the patient, and appropriate management of emotions, both for the patient's welfare and for a realistic understanding of the situation.Lessons learnedOur study confirms that an intervention confronting students with a realistic situation succeeds in making them more aware of the real issues of truth-telling. Medical students deepened their reflection over time, acquiring a deeper understanding of the relational dimension of values such as truth-telling, and honing their view of empathy.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Helping medical students to acquire a deeper understanding of truth-telling

Hurst

Baroffio

Ummel

et al. 2015

Medical Education Online

View full text Add to dashboard Cite

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“…As is apparent from our findings, although in health care it is frequently necessary to break bad news to patients, this obligation poses a major challenge to doctors and nurses, and can create difficult, painful situations [22,23]. The way in which bad news is transmitted affects the patient's understanding of the information received and hence the decisions taken in this respect, the psychological adaptation to new circumstances, participation in the process and any future changes made [24][25][26].…”

Section: Discussionmentioning

confidence: 81%

“…Studies have shown that when information is transmitted to patients and their families in sufficient quantity and quality, their anxiety is reduced and, in general, better and faster recovery is achieved and patient/carer collaboration is enhanced [23,32].…”

Section: Subcategory: Influence Of Technology Verbatimmentioning

confidence: 99%

Breaking bad news to antenatal patients with strategies to lessen the pain: a qualitative study

et al. 2018

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Background: To consider the thoughts and actions of healthcare personnel in situations when an adverse prenatal diagnosis must be communicated, including appropriate strategies and skills to respond to information needs and to manage the emotional responses of patients. Methods: Descriptive qualitative study using non-participant observation and semi-structured interviews to analyse the discourses of physicians, midwives, nurses and nursing assistants who provide healthcare to obstetric patients. Results: There may be barriers to effective communication between healthcare personnel and patients, depending on the characteristics of the persons involved, the organisation of healthcare, biotechnological progress and cultural factors. Conclusions: The human quality of healthcare has deteriorated due to excessive workloads and to the growing role played by technology. In order to improve communication, more attention should be paid to human and spiritual dimensions, prioritising empathy, authenticity and non-judgmental listening. An appropriate model of clinical relationship should be based on shared decision making, clarifying the functions of the multidisciplinary team to alleviate a mother's suffering when a pregnancy is interrupted. To do so, protocols should be implemented to ensure the provision of comprehensive care, not only addressing biological issues but also providing psychosocial attention. Finally, training should be provided to healthcare staff to enhance their social skills and cultural competence. This study identifies potential improvements in the interventions made by healthcare personnel and in the organisation of the institution, concerning the attention provided to pregnant women when an adverse prenatal diagnosis must be communicated.

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“…Healthcare providers' personal attitudes and skills can affect their ability to give information to patients, determine the type of information they should give to patients, and determine the best time and place for giving information [39]. Moreover, the abilities to manage personal emotions, manage communication, and predict the outcomes of the provided information are important for truth-telling to patients [40]. Experience, adequate professional knowledge, and self-management ability can boost nurses' self-confidence [41] and help them use more effective strategies for providing patients with information.…”

Section: Discussionmentioning

confidence: 99%

Situations of using white lie during patient care: a qualitative study into nurses’ perspectives

Nasrabadi

Joolaee

Navab

et al. 2020

Preprint

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Background: Receiving accurate and complete information about diagnosis, prognosis, and treatments is among patients’ rights in healthcare systems. Although all healthcare providers have the same viewpoint about truth-telling in the process of treatment, sometimes truths are not told to patients or they are told a “white lie”. The aim of the study was to explore nurses’ experiences of the situations of using white lie during patient care. Methods: This qualitative descriptive study was conducted in 2018. Participants were eighteen hospital nurses purposively recruited with maximum variation from ten hospitals affiliated to Tehran University of Medical Sciences, Tehran, Iran. Data were collected through semi-structured interviews. Sampling and data collection were continued up to data saturation. Data analysis was done concurrently with data collection through conventional content analysis. Results: Situations of using white-lie-telling by nurses during patient care resulted in eleven subcategories and four main categories. The main categories of the study were the crisis of hope, bad news, cultural diversity, and nurses’ limited professional competence. Conclusion: Professional knowledge, skills, and experience are needed for establishing effective communication with patients and providing them with accurate information even about bitter truths. Nurses’ communication with patients needs to be established based on adequate knowledge about the cultures of patients and healthcare organizations, and should aim to maintain patients’ hope and motivation for treatments and, should help them make accurate decisions.

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L’annonce de mauvaises nouvelles en oncologie : l’expérience belge

Cited by 8 publications

References 24 publications

Helping medical students to acquire a deeper understanding of truth-telling

Helping medical students to acquire a deeper understanding of truth-telling

Breaking bad news to antenatal patients with strategies to lessen the pain: a qualitative study

Situations of using white lie during patient care: a qualitative study into nurses’ perspectives

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