Author/Authors :
Arbabi، Mohammad نويسنده Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran , , Roozdar، Ava نويسنده Psychiatry and Psychology research center, Tehran University of Medical Science, Tehran, Iran Roozdar, Ava , Taher، Mohammad نويسنده Psychiatry and psychology research center, Tehran University of Medical Sciences, Teheran. Iran , , Shirzad، Samira نويسنده Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. , , Arjmand، Mohsen نويسنده Psychiatrist, Tehran, Iran , , Mohammadi، Mohammad Reza نويسنده Department of Physics, Sistan and Baluchestan University, Zahedan 98135–674, I.R. Iran , , Nejatisafa، Ali-Akbar نويسنده Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran , , Tahmasebi، Mamak نويسنده Cancer Institute of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran , , Roozdar، Alale نويسنده Psychiatry and Psychology research center, Tehran University of Medical Science, Tehran, Iran Roozdar, Alale
Abstract :
Objective: Bad news disclosure is one of the most complex tasks of physicians. Recent evidences indicate that patientsʹ and physiciansʹ attitude toward breaking bad news has been changed since few years ago. The evidence of breaking bad news is different across cultures. The aim of this study is to evaluate the attitude of medical staff toward breaking bad news to provide a clinical guideline in Iran.
Methods: A descriptive study was conducted during 2008-2009 on a sample of 100 medical staff (50 physicians and 50 nurses) at Cancer Institute of Imam Khomeini hospital. The subjectsʹ demographic characteristics and their attitudes toward the manner of revealing the diagnosis were registered in a questionnaire.
Results: The majority of the physicians (86%, n=43) and nurses (74%, n=37), mostly the older and more experienced, tended to reveal the diagnosis to patients. Only a few physicians (8%, n=4) had been trained how to disclose bad news, which discloused diagnosis more than non trained ones. Physicians and nurses preferred to inform the patients about the diagnosis when either the patients were alone or in the presence of their spouse respectively. Only a few physicians (14%) and nurses (24%) agreed to explain life expectancy to patients.
Conclusion: Compared to past, physicians and nurses are more willing to share cancer diagnosis with patients. However, lack of adequate communication skills in caregivers, and their concerns about managing patientsʹ emotional reactions reduce their tendency to disclose bad news to the patients. Therefore, training physicians and nurses to expose bad news to the patients seems to be necessary.