Circumstances Related to the Reporting of Bad News in the Medical Profession

Abstract

In the medical profession, communicating bad news about a malignant formation is often associated with experience, obstacles, and problems faced by the medical professionals and related to the communication with the patient. Our survey included 232 medical specialists - doctors and nurses with diverse internship in the profession and working in Bulgarian healthcare facilities. It aimed to find: (i) the most common difficulty in communicating the bad news to cancer patients, (ii) the most difficult aspects of that information, and (iii) the specific words the medical professionals prefer to avoid when communicating the bad news. Also, the medical specialists were asked about the factors with the largest interference with the disclosure of the bad news to the patients. The survey results show that only 66 percent of the medical professionals are ready to respond directly and definitively to the question from the patient if he/she has cancer. Almost all of the surveyed medical specialists believed that the most difficult part of communicating the bad news was related to the prognosis of the disease and the survival expectancy; many of the medical professionals preferred to avoid the word "cancer", and the fatality of the disease was the most common barrier in communicating bad news, followed by the relatives’ negative position towards bringing up the bad news to the patient, and the low level of patient’s education and the short life expectancy. The study shows the need for support and training of the medical professionals in addressing bad news situations and the importance of the protocols with guidelines and steps to be performed during that communication.