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Family physicians' opinions on and difficulties with breaking bad news
José António Ferraz Gonçalves1, Carla Almeida2, Joana Amorim3
1Portuguese Institute of Oncology, Palliative Care, Porto, Portugal.
Highlights:
Breaking bad news is still deemed a difficult task by family physicians.Family physicians feel they need training in breaking bad news.The family physicians' attitude to this issue is different from what they would wish if they themselves had a life-threatening disease.
Background:
Family practice is the specialty with the highest number of doctors and covers all of Portugal. Therefore, the attitude of these doctors may have a high impact on patients.
Objective:
To explore the opinion and difficulties of Portuguese family doctors on dealing with communication with patients with life threatening diseases.
Methods:
A questionnaire was sent to about 10% of family doctors of Northern Portugal. The questionnaire included questions about the disclosure of information, if they feel they need training courses and what they would want if they had a life-threatening disease.
Results:
A questionnaire was given to 196 doctors and 159 (81%) participated in this study. The median age was 43 years (26-64) and 108 (68%) were females. One hundred thirty-five (85%) consider that breaking bad news is a difficult task. One hundred twenty-four (78%) feel they need training in breaking bad news. For many doctors, the disclosure of diagnoses and prognoses has a detrimental psychological effect and affects patients' hope, but gives patients' control of the situation. Given a situation where the doctors themselves had a life-threatening disease, the vast majority would want to know the diagnosis and the prognosis and to participate in treatment decisions.
Conclusions:
Breaking bad news is still a difficult task. Their attitude to this duty is different from what they would wish if they themselves had a life-threatening disease. One important conclusion is the need of specific training in communication for family physicians that should begin in the training phase of their specialty.
Insights
Family physicians find breaking bad news challenging and desire communication training. Their approach differs from what they
Area of Science:
- Medical Communication
- Family Medicine
- Oncology
Background:
- Family practice is the largest medical specialty in Portugal, significantly influencing patient care.
- Physician communication skills are crucial for patient outcomes, especially when delivering difficult news.
Purpose of the Study:
- To investigate Portuguese family doctors' perspectives on communicating with patients facing life-threatening illnesses.
- To identify challenges faced by family physicians in delivering bad news.
- To assess family physicians' training needs in medical communication.
Main Methods:
- A questionnaire survey was distributed to approximately 10% of family doctors in Northern Portugal.
- The survey addressed information disclosure, perceived training needs, and personal preferences in life-threatening scenarios.
- 159 out of 196 (81%) family physicians participated, with a median age of 43.
Main Results:
- 85% of surveyed family physicians consider breaking bad news a difficult task.
- 78% expressed a need for specialized training in delivering bad news.
- Physicians acknowledged the psychological impact of disclosure but recognized its role in patient empowerment.
- A significant majority of physicians indicated they would want full disclosure and involvement in treatment decisions if facing a life-threatening illness.
Conclusions:
- Breaking bad news remains a significant challenge for family physicians.
- A discrepancy exists between physicians' practices and their personal preferences when facing serious illness.
- There is a clear need for dedicated communication skills training for family physicians, integrated early in their specialty education.
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