Greek Physicians' Skills and Factors Affecting Breaking Bad News to Cancer Patients

Breaking bad news is crucial for patient-centered care. This study aimed to assess physicians' skills and investigate the possible factors affecting their ability to communicate bad news.

This web-based cross-sectional survey of 633 Greek physicians included demographic and other breaking bad news related questions to evaluate their skills and practices in breaking bad news to patients with cancer.

Most physicians defined bad news (91.5%) and frequently used both verbal and non-verbal communication (82.6%). About three-quarters rated their ability to communicate bad news as good to very good (75%) and about half (50.4%) disclosed bad news in a private and comfortable setting. Emotional responses, like sadness (53.4%) and compassion (49.6%), were common, while fears mainly focused on diminishing patients' hope (60.8%) or managing patients' reactions (53.9%). Female physicians showed higher anxiety (15.9% vs. 4.3%, p < 0.0005) and sadness (53.4% vs. 43.5%, p = 0.018) and lower self-perceived competence (p = 0.001) compared to males. Specialists and physicians with formal training demonstrated greater competence (p < 0.0005) and were more likely to choose private and comfortable settings (p < 0.0005). Multivariable logistic regression identified increased age (OR = 1.03; p = 0.018), male sex (OR = 1.63; p = 0.015), formal training in breaking bad news (OR = 9.34; p < 0.0005), residence outside Athens (OR = 2.27; p = 0.002), working in oncology (OR = 1.90; p = 0.043), and employment in private hospitals (OR = 1.81; p = 0.014) as statistically significant predictors of good to very good ability to communicate bad news to cancer patients.

These findings highlight the value of structured training, targeted practice and institutional support in fostering physicians' communication skills and boosting patient-centered care.