 | Author(s) | | | McCullockh P |
| Publication | | | Professional Nurse |
| Reference | | | 19:5 |
| Publication Date | | | January 2004 |
|  |  Relevant to nurses in haematology caring for all patients.
What is the problem and what is known about it so far?
Breaking bad news is an area of practice we are all aware of, no matter how empathetic a practitioner is empathy is something each individual perceives individually, we are taught theoretically to break bad news or to go through steps but, as we all know each person (deliverer of news and recipient) has a different approach, none of these is always right.
Why did the researchers do this particular study?
After questioning patients about the way bad news had been delivered, positive responses were received but issues which were concerning were raised.
Who was studied?
A pilot study was performed of users experiences of receiving bad news, not just the delivery but also the support given post news giving. Also interestingly the role of the multidisciplinary team (MDT) were explored.
How was the study done?
60 clients were approached but only 47 responded.
The study utilised a qualitative and quantitative design, with a questionnaire tool at least one month post diagnosis, covering the setting of diagnosis, language used, privacy and dignity, support from other MDT individuals in the 1st month, whether diagnosis was acknowledged, what aspects were good, what were not so good.
The clients were asked their experiences around particular issues (qualitative). Interviews were also offered but no one asked for this service.
What were the findings?
Within the paper the study highlights areas around:
Pre clinic issues – the responders would have liked more information and to bring someone with them.
Diagnosis – by the consultant only one stated a nurse gave diagnosis. Standing or sitting – a third of the patients stated they did not know all of the people present at the consultation, and there were not enough seats, or they were partially dressed. Language used: all results show clear delivery of diagnosis, with 55% stating they were asked if they understood, and 90% felt able to ask questions. 90% stated they were given written information, which was understandable.
10% of clients felt privacy had not been respected and 5% a lack of dignity, 90% of the clients recognized that the clinical nurse specialist (CNS) was available post diagnosis to talk to. From the aspect of the MDT Little was discussed after the nurses.
When asked about good experiences clients identified a clear plan of care, with dates and agendas, not so good experiences were the number of personnel at time of diagnosis, time lag from investigation to diagnosis and the lack of privacy.
What are the implications?
All practitioners should appreciate this study, as it looks at the users of our service in an area we all feel vulnerable.
The study shows these clients in the majority felt well informed and supported but we strive to cover the last 10% therefore this study helps us to identify the areas we need to address and cover to ensure all are satisfied.
Comment by: Tracey Burgoyne, Lecturer Practitioner Cancer Care, University of Central England Birmingham, 2004.
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