Identifying Dostors' Problems In Breaking Bad News: An Initial Step In Developing Recommendations For The Curriculum

https://doi.org/10.22146/jpki.32255

Miko Ferine(1*), Gandes Retno Rahayu(2), Mora Claramita(3)

(1) Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto - INDONESIA
(2) Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta - INDONESIA
(3) Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta - INDONESIA
(*) Corresponding Author

Abstract


Background: The skill of breaking bad news is listed in the 2012 Indonesia’s Doctor Competency Standards so that this becomes one of the skills that must be mastered by all doctors in Indonesia. The curriculum of breaking bad news is much developed in western cultural background. The curriculum may not necessarily be well developed in Indonesia because the communication process is strongly influenced by culture. Therefore, the exploration of the problems faced by the practitioner in delivering bad news in the context of local cultural needs to be done as a first step to develop the right educational curriculum and training.

Objective: This study aimed to identify problems of the practicing doctors in delivering bad news to patients or their families in the context of local culture (Banyumas).

Methods: This study was a qualitative research with a phenomenological approach. The method used was in-depth interviews to the practicing doctors with experience in delivering bad news selected from various educational backgrounds, sex, and age.

Results: This study indicated that the doctors had difficulty in breaking bad news. It was known from the attitude of the doctors who tended to avoid by giving the task to others, to cover the actual condition of the patient or just delivering the bad news to the family. The causes identified were the lack of knowledge and skills, the lack of ability to control emotions, the lack of confidence, the anxiety on the patient’s response, the knowledge gap between doctors and patients, and the limitations of space and time.

Conclusion: The main problem of the practicing doctors in delivering bad news was the lack of knowledge and skills. Therefore, it is necessary to develop a training curriculum on breaking bad news adequately for basic and advanced medical education.


Keywords


Doctor, breaking bad news, communication skills, curriculum development

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References

  1. Al-Mohaimeed AA, Sharaf FK. Breaking Bad News Issues: A Survey Among Physicians. Oman Medical Journal. 2013;28(1):20-5.
  2. Hawken SJ, Henning MA. Constructing communication skills through preparation, experience, reflection and feedback. Medical Education Development. 2012; 2e6: 21-3.
  3. Barnett MM, Fisher JD, Cooke H, James PR, Dale J. Breaking bad news: consultants’ experience, previous education and views on educational format and timing. Medical Education. 2007;41: 947-56.
  4. Rosenbaum ME, Ferguson KJ, Lobas JG. Teaching Medical Students and Residents Skills for Delivering Bad News: A Review of Strategies. Academic Medicine. 2004; 79:107-17.
  5. Arbabi M, Rozdar A, Taher M, Shirzad M, Arjman M, Ansar S, Mohammadi MR. Patients’ Preference to Hear Cancer Diagnosis. Iran Journal Psychiatry. 2014; 9(1):8-13.
  6. Konsil Kedokteran Indonesia. Standar Kompetensi Dokter Indonesia. Jakarta: Konsil Kedokteran Indonesia; 2012.
  7. Payan EC, Montoya DD, Vargas JJ, Velez MC, Castano A, Krikorian A. Barriers and facilitating communication skills for breaking bad news: from the specialists’ practice perspective. Colombia Medica. 2009; 40(2):158-66.
  8. Kern DE, Thomas PA, Hughes MT. Curriculum Development for Medical Education A Six Steps Approach. Maryland: The John Hopkins University Press; 2009.
  9. Buckman R. Breaking bad news: why is it still so difficult? British Medical Journal. 1984;288:1597-9.
  10. Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES-A Six-Steps Protocol for Delivering Bad News: Application to the Patient with Cancer. The Oncologist. 2000; 5: 302-11.
  11. Konsil Kedokteran Indonesia. Komunikasi Efektif Dokter-Pasien. Jakarta: Konsil Kedokteran Indonesia; 2006.
  12. Kagawa-Singer M, Blackhall LJ. Negotiating Cross-Cultural Issues at the End of Life “You Got to Go Where He Lives”. Journal of American Medical Association. 2000; 286(23): 2993-3001.
  13. Moustakas C. Phenomenological research methods. California: Sage Publications, Inc.; 1994.
  14. Harper D, Thompson AR. Qualitative research methods in mental health and psychotherapy: A guide for students and practitioners. Sussex: John Wiley & Sons, Ltd.; 2012.
  15. Creswell JW. Research design: Qualitative, quantitative, and mixed methods approaches. Los Angeles: Sage Publication; 2009.
  16. Vandekieft GK. Breaking Bad News. American Family Physician. 2001;64:1975-8.
  17. Hulsman RL, Pranger S, Koot S, Fabriek M, Karemaker JM, Smets EMA. How stressful is doctor-patient communication? Physiological and psychological stress of medical students in simulated history taking and bad-news consultations. International Journal of Psychophysiology. 2010; 77(20): 26-34.
  18. Salem A, Salem AF. Breaking Bad News: Current Prospective and Practical Guideline for Muslim Countries. Journal of Cancer. 2013: 28; 790-4.
  19. Tavakol M, Murphy R, Torabi S. Educating doctors about breaking bad news: an Iranian perspective. Journal Cancer Education. 2008; 23(4): 260-3.
  20. Hagerty RG, Bullow PN, Ellis PM, Dimitry S, Tattersall MHN. Communicating prognosis in cancer care: a systematic review. Annuals of Oncology. 2005;16: 1005-53.
  21. Claramita M, Prabandari Y, van Dalen J, van der Vleuten CPM. Doctor-patient communication guideline that is tailored to Southeast Asian context. Southeast Asia Journal of Medical Education. 2010; 4(2): 23-30.
  22. Castel OC, Ungar L, Mordechal A, Amiel GE, Karkabi K. Family Physicians’ Perceptions, Beliefs and Attitudes Regarding Information Sharing with Prostate Cancer Patients Throughout The Course of The Disease. Support Care Cancer. 2008; 16: 955-61.
  23. Martis L, Westhues A. A focus on the burdens, boosters and bonuses of the bearers of bad news in Indonesia. International Journal of Medical Education. 2013; 4: 126-38.
  24. Locatelli C, Piselli P, Cichercia M, Repetto M. Physicians’ age and sex influence breaking bad news to elderly cancer patients. Beliefs and practices of 50 Italian oncologists: the G.I.O.Ger study. Psycho-Oncology. 2013; 22: 1112-9.



DOI: https://doi.org/10.22146/jpki.32255

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