Breaking bad News in Different Medical Conditions : Exploring the Physicians and Patients Perspectives.

Abstract

Background: We aim to explore factors influencing the breaking bad news process in different medical contexts with irreversible conditions (others than cancer). Methods: 23 patients and 18 physicians concerned by different chronic diseases were interviewed by psychologists. They received/broke bad news in the few months preceding the interview. Findings: Thematic analysis of interviews allowed to identify higher-order themes, and more specific themes for both, patients and physicians. The main topics covered by physicians concerned the determinants of the strategies to communicate with patients, the encountered difficulties, the initial training, the information, interpersonal relationships, emotional reactions, perception of its role, the specifics of the disease. The discourse of patients referred to three stages including specifics topics: the communication of bad news, the health care pathways, and the life with disease. Discussion: Data analysis highlight importance of patient and physician’s profiles, and specifics of disease, in the breaking bad news process. Recommendations to build tailored intervention for physicians by using formative self-assessment will be exposed.