[Giving bad news in medicine: an exploratory study]

Abstract

Giving bad news is inherent to the practice of medicine. Development of guidelines for this task has great value, although the orientations are only general and should be adapted to each case, allowing for the cultural idiosyncrasy of the people involved.

Objectives: the present study aims to explore common practices of giving bad news in different hospital services in Santiago-Chile.

Materials and methods: a qualitative methodology was applied through three focus groups with a sample of 33 physicians from two hospitals in Santiago-Chile.

Results: giving bad news is a frequent practice for which no training is given. It generates preoccupation and interest among professionals. There is no agreed procedure to communicate bad news. Each professional has had to develop his/her own way from his/her experience and observing others. Informing the patient is seen as an ethical duty, but in many cases it is not easy because of family pressure. Comments are made on different types of bad news, strategies for this communicational process and facilitators and barriers for it.

Conclusion: Doctors' own professional past experience is a central factor in the way bad news is given, and so self-development mechanisms constitute an important challenge.