Konstantis Apostolos, Exiara Triada
Department of Internal Medicine, General Hospital of Komotini, Komotini, Greece.
Indian J Palliat Care. 2015 Jan-Apr;21(1):35-8. doi: 10.4103/0973-1075.150172.
In a regional hospital, many patients are newly diagnosed with cancer. Breaking the bad news in these patients and their relatives is a tough task. Many doctors are not experienced in talking to patients about death or death-related diseases. In recent years, there have been great efforts to change the current situation. The aim of this study was to investigate the experience and education of medical personnel in breaking bad news in a secondary hospital.
59 doctors from General Hospital of Komotini, Greece were included in the study. All the doctors were in clinical specialties that treated cancer patients. A brief questionnaire was developed based on current guidelines such as Baile/SPIKES framework and the ABCDE mnemonic.
Residents are involved in delivering bad news less frequently than specialists. Only 21 doctors (35.59%) had specific training on breaking bad news. 20 doctors (33.90%) were aware of the available techniques and protocols on breaking bad news. 47 doctors (79.66%) had a consistent plan for breaking bad news. 57 (96.61%) delivered bad news in a quiet place, 53 (89.83%) ensured no interruptions and enough time, 53 (89.83%) used simple words and 54 (91.53%) checked for understanding and did not rush through the news. 46 doctors (77.97%) allowed relatives to determine patient's knowledge about the disease.
There were low rates of specific training in breaking bad news. However, the selected location, the physician's speech and their plan were according to current guidelines.
在一家地区医院，许多患者是新确诊的癌症患者。向这些患者及其亲属传达坏消息是一项艰巨的任务。许多医生在与患者谈论死亡或与死亡相关的疾病方面缺乏经验。近年来，人们为改变现状做出了巨大努力。本研究的目的是调查一家二级医院医务人员在传达坏消息方面的经验和教育情况。
纳入了希腊科莫蒂尼综合医院的59名医生。所有医生均从事治疗癌症患者的临床专科工作。根据当前指南，如贝利/ SPIKES框架和ABCDE记忆法，编制了一份简短问卷。
住院医师比专科医生传达坏消息的频率更低。只有21名医生（35.59%）接受过关于传达坏消息的专门培训。20名医生（33.90%）了解现有的传达坏消息的技巧和方案。47名医生（79.66%）有传达坏消息的一致计划。57名（96.61%）在安静的地方传达坏消息，53名（89.83%）确保没有干扰且有足够时间，53名（89.83%）使用简单的语言，54名（91.53%）检查患者是否理解且不急于传达消息。46名医生（77.97%）让亲属决定患者对疾病的了解程度。
传达坏消息的专门培训率较低。然而，所选的地点、医生的讲话方式及其计划符合当前指南。
