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. 2023 Dec;33(14):1349-1359.
doi: 10.1177/10497323231197534. Epub 2023 Oct 4.

Physicians' Lived Experience of Breaking Bad News in Clinical Practice: Five Essentials of a Relational Process

Mattias Tranberg  1   2 , Eva M Brodin  3   4
Affiliations

Physicians' Lived Experience of Breaking Bad News in Clinical Practice: Five Essentials of a Relational Process

Mattias Tranberg et al. Qual Health Res. 2023 Dec.

Abstract

The purpose of this study was to develop deeper knowledge about physicians' lived experiences of breaking bad news by identifying their common meanings and interrelatedness along with their potential alignment with process-oriented and relational aspects. Based on the methodology of descriptive phenomenology, in-depth interviews were conducted with 22 physicians from a wide variety of specialties. The participants were invited to freely reflect upon their experiences of breaking bad news by describing situations that had worked well and less well. Results showed that breaking bad news was fundamentally experienced as a relational process constituted by the five essentials of Becoming the bad messenger, Expecting the unpredictable, Being on stage, Professionally managing hope, and Mindfulness of the emotional relationship. In line with recent research, this study confirms that clinical communication involves much more than just delivering the message. However, it also contributes to existing knowledge by focusing on the phenomenology of physicians' experiences, which enables deeper understanding of the medical profession and the relational process of breaking bad news. As such, our findings are important to enable broader learning in, for example, medical education and continuing courses for clinical staff.

Keywords: communication; patients; phenomenology; physicians; serious illness.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Breaking bad news as a relational process.
See this image and copyright information in PMC

References

    1. Alshami A., Douedi S., Avila-Ariyoshi A., Alazzawi M., Patel S., Einav S., Surani S., Varon J. (2020). Breaking bad news, a pertinent yet still an overlooked skill: An international survey study. Healthcare (Basel), 8(4), 501. 10.3390/healthcare8040501 - DOI - PMC - PubMed
    1. Applbaum A. I. (2017). The idea of legitimate authority in the practice of medicine. AMA Journal of Ethics, 19(2), 207–213. 10.1001/journalofethics.2017.19.2.sect1-1702 - DOI - PubMed
    1. Back A., Tulsky J., Baile W., Arnold R., Fryer-Edwards K. (2009). Mastering communication with seriously ill patients : Balancing honesty with empathy and hope. Cambridge University Press.
    1. Baile W. F., Buckman R., Lenzi R., Glober G., Beale E. A., Kudelka A. P. (2000). SPIKES-A six-step protocol for delivering bad news: Application to the patient with cancer. The Oncologist, 5(4), 302–311. 10.1634/theoncologist.5-4-302 - DOI - PubMed
    1. Beck C. T. (2021). Introduction to phenomenology : Focus on methodology. Sage Publications, Inc.