Patient preferences for the delivery of bad news - the experience of a UK Cancer Centre

Abstract

The primary aim of this study was to assess how patients would prefer to be given their cancer diagnosis in a typical UK cancer centre. Two hundred and forty-four patients attending the oncology outpatient department at the Leicester Royal Infirmary, UK, were recruited. Patients were invited to complete the Measure of Patients' Preferences questionnaire, write comments on their own experience of the breaking bad news consultation and choose their preferred role in decision making. Over 90% of questionnaires were completed. Patients rated the items addressing the message content of the consultation as more important than the facilitative or the supportive aspects. Over 80% of patients wrote a detailed account of their experiences, of which 60% were satisfied with the consultation. Most of the patients who were dissatisfied commented on the unsympathetic or pessimistic manner of the doctor. The majority of patients wanted a collaborative role in decision making. Regarding the cancer diagnosis, the majority of patients have information needs, want to be involved in treatment decisions and know their prognosis. The difficulty for physicians is how to meet individual information needs, give hope, but not deliver unrealistic expectations.

The effect of communication skills training on residents’ physiological arousal in a breaking bad news simulated task

“…Poor BBN may have a negative impact on patients' satisfaction with care [1], adherence to treatment [2], decisions about treatment options [3] and psychological adjustment [4]. Reviews about BBN have been published and there is now a wide consensus that BBN requires specific communication skills.…”

Here Comes the Bad News: Doctor Robot Taking Over

“…Doctors prefer to sweeten the bitter pill by using negations such as "The news is not so good," whereas patients wish to know what doctor actually thinks [7]. Could it be that the robot is not suspected of doubt and reservation?…”

How relatives of patients with head and neck cancer experience pain, disease progression and treatment: A qualitative interview study

“…This might partly be related to the seriousness of the diagnosis. Such a reaction stresses the importance of delivering a cancer diagnosis gently and appropriately (Brown et al, 2011;Fujimori and Uchitomi, 2009;Ptacek and Ptacek, 2001) so as to minimize the shock of such a serious diagnosis (Cavers et al, 2012).…”