| Warnock(8)
|
England |
English |
Case study |
A patient with a chronic disease who needs to receive bad news |
Nurses are responsible for a range of releases of bad news. The study shows difficulties and facilitators for good communication. It also shows that nurses are so involved in the process of communicating bad news that it ends up strengthening their relationship with their patients and families, benefiting the nurse-patient relationship |
Analytical analysis of the data presented in the case and exploratory analysis of literature review to show the best techniques for communicating bad news |
It is important to recognize nurses in the process of delivering bad news, and it is essential to prepare, guide, and train their communication skills |
VII |
| Rocha et al.(11)
|
Brazil |
Portuguese |
Reflective study |
Studies published in recent years, searched in a broad and non-systematic way, to foster debate on the subject and bring insight as to the topic of communicating bad news |
The study places communication of bad news as a role of nurses as much as of physicians. To convey effective news, it must be given gradually and clearly, in conversation with the team, observing the emotional aspects of the patient and family members, and offering attentive and humanized listening. The authors also emphasize that there is no universal technique that works for everyone. Thus, it is necessary to act according to the ethical principles of justice, autonomy, beneficence, and non-maleficence |
Reflective data analysis after literature review |
Communicating bad news involves all professionals associated with the patient. In the obstetric scenario, it mainly involves the mother and family members. It is important to emphasize that in humanized and harmonious communication, it is necessary to pay attention to verbal and non-verbal communication. Moreover, due to the lack of studies in the literature on the communication of bad news by nurses, organizing training courses to develop such skills is suggested |
VII |
| Amorim et al.(18)
|
Brazil |
Portuguese |
Qualitative, descriptive, and exploratory study |
15 nurses from 10 Primary Healthcare Units located in the South Region of Brazil |
According to the nurses who participated in the study, the barriers found in communicating bad news were related to service demand, work organization, user characteristics, and personal aspects. The advantages pointed to privacy and the fact of being in the community. Some points fit both in the barriers and facilitating communication: operation of the network, the team, professional training, professional experience, and personal aspects |
Discourse analysis |
There is scarce approach to the subject of “communicating bad news” during professional training. This creates a series of barriers for professionals. It is important that the subject is taken to educational organizations, for a discussion of the subject and the development of courses/materials on communication |
VI |
| Corey et al.(19)
|
United States |
English |
Qualitative, exploratory, and descriptive study |
5 nursing professionals, with 2 to 10 years of experience, from 2 working groups (Central Florida Chapter of the Oncology Nursing Society e Greater Orlando Hematology Oncology Physician Extenders) |
The experiences of nurses in communicating bad news are based on their own communication skills. Although not appearing in several studies as the deliverer of bad news, nurses are professionals who experience this practice in their daily lives. Thus, it is necessary to develop their skills, especially in training environments. The use of the SPIKES protocol outside the context of oncology is seen as advantageous for those who want to start their studies in the field and put into practice the communication of bad news in a proper way |
Extraction of common themes, from accounts, validation, and reliability by the triangulation method, concept verification, and grouping |
It is essential to promote the development of communication skills in healthcare professionals, especially nurses, and to ensure emotional support to patients. In addition, the use of protocols for communicating bad news is important to assist in the development of such skills. The study shows a good use of the SPIKES protocol, and the interviewed nurses indicated they would continue with the use of SPIKES and recommend it to fellow professionals |
VI |
| Imanipour et al.(20)
|
Iran |
English |
Descriptive and cross-sectional study |
160 nurses from the intensive care units of hospitals affiliated with the Faculty of Medical Sciences of the University of Tehran |
Nurses, especially from critical care, are directly involved in communicating bad news by playing different roles, providing emotional support to the patient and family, clarifying doubts and medical words in simple language, and preparing the patient and family to receive the bad news. “In this study, 78.8% of nurses had moderate knowledge on how to communicate bad news and few had a good level of knowledge (16.2%)” |
Statistical analysis of the participants’ answers using the Statistical Package for the Social Science, version 2.0, and clustering of the main answers |
Although the study shows the important role of nurses in communication of bad news and their positive attitude in the process, an inadequate level of knowledge required for good communication is demonstrated. Thus, it is necessary to create educational programs to improve the nurses’ communication skills |
VI |
| Warnock et al.(21)
|
England |
English |
Descriptive and cross-sectional study |
236 nursing professionals, including nursing coordinators, lecturers, head nurses, staff nurses, specialists, and midwives in National Health Service teaching hospitals, in the United Kingdom |
Nurses participated in breaking bad news in all types of care. They proved to be unprepared, many times, by being caught off guard in having to deliver bad news, and by not having adequate training that would enable them to disclose bad news effectively. In addition, it is important to carry out the process of team communication. Nurses are often called by the patients themselves for clarification of misunderstood terms said by the doctors |
Descriptive statistics from the coding of answers to the questionnaires, as per their contents and subsequent grouping by similar themes. The information was crossed, generating themes and categories. Finally, the codes, themes, and categories were compared, generating the final interpretation |
“Guidance on breaking bad news must encompass the entire process of doing so and recognizing the challenges nurses face in the inpatient clinical field. Developments in education and support are needed that reflect the challenges nurses face in the inpatient care setting” |
VI |
| Warnock et al.(22)
|
England |
English |
Descriptive and cross-sectional study |
145 participants including nurses and other health professionals, working in the medical field in a region of northern England |
The study provides a list of several difficulties presented by nurses of the service, at the time or in the process of breaking bad news. “Traditional issues, such as information on diagnosis and treatment, were described, but additional topics were identified, such as the impact of illness and end-of-life care.” A description was made of the issues most present as difficulties at the time of disclosure; these were: organization, the situation in which the disclosure is made, reactions and issues related to the patient and their families; and finally, personal issues, such as lack of skills or confidence |
Structural analysis of the obtained data, with independent and collaborative phases, which identified some preliminary thematic indexes. Then, the similarities and differences were evaluated forming the final thematic index |
The study provides “an understanding of the scope of challenges faced by staff”, when they are involved in the process of breaking bad news. With this, it is possible to see the importance of developing courses that improve the communication skills of professionals, especially in a way that focuses on their clinical practice |
VI |
| Hemming(23)
|
England |
English |
Case study |
A patient with a chronic disease, who has experienced several situations of receiving bad news from staff |
Nurses play a central role in communicating bad news because they are in direct contact with the patient for longer than other professionals. In addition, establishing bonds makes them listen better to their patients and inform them of the news, according to their concerns, needs, and understanding. Also, good communication requires teamwork. Training in advanced communication skills has proven useful in the practice of conveying bad news |
Exploratory and analytical analysis, based on current literature data, compared with the presented report |
Specialist nurses proved to be very valuable in communicating bad news, mainly because of trust that is created between them and their patients/family members. Thus, the communication of bad news affects patients in different ways, educating them about the subject and reinforcing the idea of the need for more organizational investments in developing communication skills of its professionals |
VII |
| Rosenzweig(24)
|
United States |
English |
Reflective study |
Extensive use of literature data, and of the SPIKES protocol |
Patient-centered communication ensures a better quality of care. Thus, when communicating bad news, nurses must maintain a plan to avoid errors in the process and ensure a good understanding in the communication, always based on empathy. The study shows the benefits of the SPIKES protocol for those who are at the beginning of their learning process regarding communication of bad news |
Qualitative data analysis, comparing the use of the protocol with other communication data, and analyzing the existing content on the topic |
The ability to communicate bad news is something that can be learned through communication development courses. These can and should be included in educational organizations around the world. Properly communicating bad news and using a protocol promotes a more comfortable process for nurses and their patients. This improves the overall communication among nurses and patients/family members |
VII |
| Uveges et al.(25)
|
United States |
English |
Case study |
1 nurse and 1 patient in a case report on the ethical aspect of the professional in communicating or not communicating bad news to patients and families |
Nurses who work in intensive care units constantly participate in the delivery of bad news, either by clarifying technical terms, attending multidisciplinary meetings, assisting in the understanding of difficult news, and helping to discern the implications of the disease/condition. In addition, some patients and families prefer bedside conversations rather than meetings with the team. The study shows a nurse’s unpreparedness when faced with the ethical act of communicating, or not, bad news |
Analytical analysis of the events that occured were describe in the report and compared to what the literature brings as best practice |
Nurses are participants in the process of communicating bad news, which is not a one-time process, but one that occurs throughout the course of care. They act as educators, facilitators, and supporters of the patient and their family members during the communication. Therefore, the process must be done within ethical principles and the patient’s preferences. Their skills must be developed for best practice |
VII |
Thumbnail
