Models on Breaking Bad News

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HPSY401 – HEALTH BEHAVIOUR CRITICALLY EVALUATE ANY MODELS ON HOW TO BREAK BAD NEWS Bad news may be defined as “any information which adversely and seriously affects an individual's view of his or her future”. (Placek JT, Eberhardt TL 1996). Buckman (1984) considers bad news to be ‘news that alters a person’s view of the future: drastically and negatively’, Bad news is always, however, in the “eye of the beholder,” such that one cannot estimate the impact of the bad news until one has first determined the recipient's expectations or understanding. Recently, there has been a renewed interest in developing specific educational initiatives to prepare healthcare professionals in breaking bad news. While most initiatives have previously focused on medical staff, some now offer training to a wider range of healthcare professionals (Blok et al, 1999). Over the course of a career, a busy clinician may disclose unfavorable medical information to patients and families many thousands of times. Breaking bad news to patients is inherently aversive, described as “hitting the patient over the head” or “dropping a bomb”. Breaking bad news can be particularly stressful when the clinician is inexperienced, the patient is young, or there are limited prospects for successful treatment. Bad news must be told because of the following reasons:  Patients Want the Truth  Ethical and Legal Imperatives  Clinical Outcomes However, breaking bad news is also a complex communication task. In addition to the verbal component of actually giving the bad news, it also requires other skills. These include responding to patients' emotional reactions, involving the patient in decision-making, dealing with the stress created by patients' expectations for cure, the involvement of multiple family members, and the dilemma of how to give hope when the situation is bleak. (Taylor C. 1988).

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