Breaking bad news in spinal cord injury; a qualitative study assessing the perspective of spinal cord injury survivors in Turkey

Critical Care Nurses’ Attitudes, Roles, and Barriers Regarding Breaking Bad News

This study examines critical care nurses’ attitudes, roles, experience, education, and barriers regarding breaking the bad news. A descriptive, cross-sectional design was used in this study. A convenience sample of 210 critical care nurses completed the study. Most of the critical care nurses contributed to breaking bad news and they were involved in different roles in this process and they had a positive attitude regarding breaking bad news. In this study, (75.2%) of the participants reported that they did not receive any specific training regarding breaking bad news. In addition, nurses face various barriers when breaking bad news. Critical care nurses’ involvement in breaking bad news should be encouraged. Most barriers to BBN were negatively associated with nurses’ roles, attitudes, and experiences during BBN. Administrators should promote the involvement of critical care nurses in breaking bad news and strengthen them through addressing the challenges they face in the process of BBN.

Experiences and views of receiving and delivering information about recovery in acquired neurological conditions: a systematic review of qualitative literature

OBJECTIVE

To review and synthesise qualitative literature relating to the views, perceptions and experiences of patients with acquired neurological conditions and their caregivers about the process of receiving information about recovery; as well as the views and experiences of healthcare professionals involved in delivering this information.

DESIGN

Systematic review of qualitative studies.

DATA SOURCES

MEDLINE, Embase, AMED, CINAHL, PsycINFO, Web of Science and the Cochrane library were searched from their inception to July 2019.

DATA EXTRACTION AND SYNTHESIS

Two reviewers extracted data from the included studies and assessed quality using an established tool. Thematic synthesis was used to synthesise the findings of included studies.

RESULTS

Searches yielded 9105 titles, with 145 retained for full-text screening. Twenty-eight studies (30 papers) from eight countries were included. Inductive analysis resulted in 11 descriptive themes, from which 5 analytical themes were generated: the right information at the right time; managing expectations; it's not what you say, it's how you say it; learning how to talk about recovery and manage emotions; the context of uncertainty.

CONCLUSIONS

Our findings highlight the inherent challenges in talking about recovery in an emotional context, where breaking bad news is a key feature. Future interventions should focus on preparing staff to meet patients' and families' information needs, as well as ensuring they have the skills to discuss potential recovery and break bad news compassionately and share the uncertain trajectory characteristic of acquired neurological conditions. An agreed team-based approach to talking about recovery is recommended to ensure consistency and improve the experiences of patients and their families.

Evaluation of emergency medical services staff knowledge in breaking bad news to patients

Objective

The aim of the study was to investigate knowledge of breaking bad news (BBN) among medical personnel in the emergency medical services (EMS).

Methods

A cross-sectional survey was conducted of 148 individuals employed in EMS. An interview was conducted using a structured questionnaire.

Results

Of study participants, 89.2% were not aware of any formal BBN procedure and 58.1% had not participated in any form of training. Compared with males, females were more likely to report that dealing with the emotional state of the family or the patient was the most difficult aspect of BBN. Only a few participants were aware of the SPIKES protocol for BBN, and none knew what the acronym meant. Sex, educational level, occupation, work experience and workplace were not associated with knowledge of BBN procedures.

Conclusions

Knowledge of BBN in both male and female EMS staff was insufficient. EMS personnel held different opinions about the method of BBN. Even staff who have participated in specific BBN training or have extensive professional experience were pessimistic about BBN skills in self-assessments.