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Communication of bad news in the medical work: a look at the patient with poor prognosis

Abstract

The communication process is central to the doctor-patient relationship. It is a fact that to avoid dysthanasia, palliative care must be available as an alternative. Thus, the objective was to evaluate the quality of bad news communication performed by physicians from the perspective of patients in the process of finitude, comparing their rates between those in palliative care and those in dysthanasia. A quantitative research was carried out, with a non-probabilistic sample, made up of 234 cancer patients in the process of dying, coming from five hospital units in the state of Ceará, Brazil, who answered two questionnaires-one biodemographic and the other assessing communication, analyzed by means of descriptive and bivariate statistics. The results demonstrated the importance of the doctor-patient relationship. While dysthanasia patients expressed that they were better prepared for establishing adequate communication, those in palliative care reported a less negative experience regarding “communicating bad news”-the result of adequate preparation by the palliative care physician as well as effective family participation in the therapeutic decision. It is concluded that the steps of preparation for communication, transmission of information, reception and closure should be based on identifying the patients’ prior content about the disease and their expectations of information.

Keywords:
doctor-patient communication; palliative care; oncology; death

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