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Breaking Bad News: A contextual model for Pakistan
Lubna Baig1, Sana Tanzil2, Syeda Kauser Ali3
1Prof. Dr. Lubna Baig, MBBS, MPH, MMEd FCPS, PhD, APPNA Institute of Public Health, Jinnah Sind Medical University, Karachi, Pakistan.
Pakistan Journal of Medical Sciences
|December 19, 2018
Summary
Healthcare providers in Pakistan face violence after delivering bad news due to impatience and unmet expectations. A new communication model effectively de-escalates these violent encounters.
Area of Science:
- Medical Communication
- Healthcare Violence
- Pakistan Healthcare System
Background:
- Violence against healthcare providers is a significant issue globally.
- Context-specific factors influencing patient-provider interactions in Pakistan require investigation.
Purpose of the Study:
- To identify the sequence of events leading to violence after breaking bad news.
- To develop a contextual model for breaking bad news in Pakistan.
Main Methods:
- Qualitative exploratory study utilizing six focus group discussions (FGDs) and 14 in-depth interviews (IDIs).
- Participants included healthcare providers from emergency and obstetrics/gynecology departments in tertiary care hospitals in Karachi, Pakistan.
- Thematic content analysis was employed to identify key themes and subthemes.
Main Results:
- Key triggers for violence identified: impatience, lack of respect, and unrealistic expectations.
- A five-step conceptual model for communicating bad news was developed.
- Initial testing indicated the model's effectiveness in de-escalating violence.
Conclusions:
- Effective communication of bad news necessitates context-specific strategies.
- Addressing contextual challenges is crucial for reducing violence against healthcare professionals.
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