Miller Elizabeth M, Porter Joanne E, Barbagallo Michael S
Collaborative Evaluation & Research Group (CERG), Federation University Australia, Churchill, VIC, Australia.
Palliat Support Care. 2024 Oct;22(5):913-919. doi: 10.1017/S1478951522001845.
Receiving bad news about one's health can be devastating, yet little is known about how the therapeutic nature of the environment where bad news is delivered affects the experience. The current study aimed to explore how patients and their families were affected by the language and the built, natural, social, and symbolic environments when receiving bad news, through the Therapeutic Landscapes theoretical framework.
Patients diagnosed with a life-limiting illness living in regional Victoria who had a hospital admission within 24 months and a diagnostic/prognostic conversation were invited to participate, as well as a family member who witnessed the conversation. Participants were recruited through social media and snowballing, resulting in 14 online semi-structured interviews being conducted between November 2021 and March 2022, audio-recorded, and transcribed verbatim. Reflexive thematic analysis was used to develop the themes.
Fourteen semi-structured interviews were conducted with women aged between 30 and 77 years. Interviews lasted between 45 and 120 minutes, with an average of 69 minutes, and were conducted online or via mobile phone. Four central themes were developed: "Hearing bad news for the first time," "Preferences for having hard conversations," "Creating a sense of safety for ongoing care," and "The therapeutic nature of the ward."
This body of work will help inform practice and future policy regarding bad news delivery and the design and aesthetics of environments where bad news is delivered. It is essential that bad news is delivered within a quiet, calm, and emotionally safe environment within a supportive therapeutic relationship.
得知关于自身健康的坏消息可能是毁灭性的，然而对于传递坏消息的环境的治疗性质如何影响这一体验，我们却知之甚少。本研究旨在通过治疗性景观理论框架，探讨患者及其家人在接收坏消息时，语言以及建筑、自然、社会和象征环境是如何对他们产生影响的。
邀请居住在维多利亚州地区、在24个月内有过住院经历且进行过诊断/预后谈话的被诊断患有危及生命疾病的患者，以及目睹该谈话的一名家庭成员参与研究。通过社交媒体和滚雪球式招募参与者，于2021年11月至2022年3月期间进行了14次在线半结构化访谈，进行了录音并逐字转录。采用反思性主题分析来提炼主题。
对年龄在30至77岁之间的女性进行了14次半结构化访谈。访谈持续时间在45至120分钟之间，平均为69分钟，通过在线或手机进行。提炼出了四个核心主题：“首次听到坏消息”“进行艰难谈话的偏好”“为持续护理营造安全感”以及“病房的治疗性质”。
这项工作将有助于为有关坏消息传递以及传递坏消息的环境的设计和美学的实践及未来政策提供参考。在支持性的治疗关系中，在安静、平静且情感安全的环境中传递坏消息至关重要。
