Sánchez Antonio Ramos, Beltrán María Jesús Martínez, Arribas Marín Juan Manuel, de la Torre-Montero Julio C, Gil Beatriz Blanco, García María Del Carmen Massé, Ribeiro Ana Sofia Fernandes
Escuela de Enfermería y Fisioterapia San Juan de Dios, Universidad Pontificia Comillas, Ciempozuelos, Spain.
Equipo de Soporte de Atención Paliativa Domiciliaria de Villalba, Área Noroeste, Gerencia de Atención Primaria de la Comunidad de Madrid, Madrid, Spain.
Am J Hosp Palliat Care. 2024 Jan;41(1):26-37. doi: 10.1177/10499091231163323. Epub 2023 Mar 21.
Communication is one of the central axes around which end-of-life care revolves in the context of palliative care. Communication of bad news is reported as one of the most difficult and stressful tasks by palliative care professionals. Therefore, the aim of this study is to identify aspects related to the communication of bad news in palliative care in Spain.
Descriptive cross-sectional study. An ad hoc questionnaire was designed and sent by e-mail to all palliative care teams in Spain.
Overall, 206 professionals (102 nurses, 88 physicians and 16 psychologists) completed the questionnaire. A total of 60.2% considered their communication of bad news skills to be good or very good. This was related to older age, experience in both the profession and palliative care, and to having received specific postgraduate training ( < .001). Around 42.2% perform communication of bad news with the patient first, which is associated with lower skill ( = .013). About 78.15% of the professionals do not use any specific protocol.
This study suggests that patients access palliative care with little information about their diagnosis and prognosis. The barriers identified in the communication of bad news are the lack of specific education and training in protocol management, the difficult balance between hope and honesty, the young age of the patient, and the family.
在姑息治疗背景下，沟通是临终关怀围绕的核心轴线之一。据报道，传达坏消息是姑息治疗专业人员最困难和压力最大的任务之一。因此，本研究的目的是确定西班牙姑息治疗中与传达坏消息相关的方面。
描述性横断面研究。设计了一份专门问卷，并通过电子邮件发送给西班牙所有姑息治疗团队。
总体而言，206名专业人员（102名护士、88名医生和16名心理学家）完成了问卷。共有60.2%的人认为他们传达坏消息的技能良好或非常好。这与年龄较大、在该职业和姑息治疗方面的经验以及接受过特定的研究生培训有关（P<0.001）。约42.2%的人首先与患者进行坏消息的沟通，这与较低的技能相关（P=0.013）。约78.15%的专业人员不使用任何特定方案。
本研究表明，患者在对其诊断和预后了解甚少的情况下接受姑息治疗。在传达坏消息方面发现的障碍包括在方案管理方面缺乏特定的教育和培训、希望与诚实之间难以平衡、患者年龄小以及家庭因素。
