Related Experiment Video
Updated: Nov 9, 2025

Continuous Theta Burst Stimulation of the Posterior Medial Frontal Cortex to Experimentally Reduce Ideological Threat Responses
Published on: September 28, 2018
Development and validation of The Breaking Bad News Attitudes Scale
Kátia Laureano Dos Santos1, Paola Gremigni2, Giulia Casu2
1Centro Universitário FMABC, Faculdade de Medicina do ABC, Av Príncipe de Gales, 821, Santo André, 09060-650, Brazil.
Background:
Communication of bad news plays a critical role in the physician-patient relationship, and a variety of consensus guidelines have been developed to this purpose, including the SPIKES protocol. However, little is known about physicians' attitudes towards breaking bad news and to be trained to deliver it. This study aimed to develop and validate a self-report questionnaire to assess physicians' attitudes towards principles of the SPIKES protocol and training on them.
Methods:
The Breaking Bad News Attitudes Scale (BBNAS) was administered to 484 pediatricians and 79 medical students, recruited at two scientific conferences and two medical schools in Brazil. The questionnaire structural validity, reliability, and associations with other variables were tested.
Results:
The BBNAS showed adequate validity and good reliability, with two factors measuring attitudes towards the SPIKES strategy for braking bad news (α = 0.81) and the possibility to be trained on it (α = 0.77), respectively.
Conclusion:
The novel questionnaire is a psychometrically sound measure that provides information on physicians' agreement with the SPIKES protocol. The BBNAS can provide useful information for planning training and continuing education programs for clinicians on communication of bad news using the SPIKES as a framework.
Related Concept Videos
Attitudes
Self-Report Tests of Personality
Confirmation Biases
Self-Discrepancy Theory
Lazarus's Cognitive Appraisal Theory
Primary Appraisal:...
Need for Self-Esteem

