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医疗服务中的坏消息告知:一项全面的系统评价。

Breaking bad news in medical services: a comprehensive systematic review.

作者信息

Jalali Rostam, Jalali Amir, Jalilian Milad

机构信息

Nursing Department, Nursing & Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Department of Psychiatric Nursing, Nursing & Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Heliyon. 2023 Mar 22;9(4):e14734. doi: 10.1016/j.heliyon.2023.e14734. eCollection 2023 Apr.

DOI:10.1016/j.heliyon.2023.e14734
PMID:37025874
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10070541/
Abstract

OBJECTIVE

This study was performed with the aims of screening the previous studies on breaking bad news in all medical wards.

METHODS

Eligible observational studies were selected. The quality of the studies was assessed using the STROBE checklist. The findings were reported using Garrard's table. All the stages of the present study were performed in terms of the PRISMA statement.

RESULTS

Totally, 40 articles were included in the study and 96 items were extracted. The results show that breaking bad news is a recipient-centered process. Respect, empathy, and support were reported. The news presenters are better to use guidelines based on evidence-based findings. It is suggested that the presenter should use simple and understandable content. Moreover, suitable time and space are important to present the news. The results show the importance of paying enough attention to the emotions of the recipient and the need to provide support after breaking bad news.

CONCLUSION

The recipient must be the center of the programs. It is necessary to pay attention to the characteristics of the news presenter, the news content, and finally the support.Practice Implication: Understand the recipient, trained presenter, and use of the evidence-based results, improve the breaking bad news outcome.

摘要

目的

本研究旨在筛选所有医学科室中关于告知坏消息的既往研究。

方法

选取符合条件的观察性研究。使用STROBE清单评估研究质量。研究结果采用加拉德表格进行报告。本研究的所有阶段均按照PRISMA声明进行。

结果

本研究共纳入40篇文章,提取了96项内容。结果表明,告知坏消息是以接受者为中心的过程。研究报告了尊重、同理心和支持等方面。消息传达者最好使用基于循证结果的指南。建议传达者使用简单易懂的内容。此外,合适的时间和空间对于传达消息很重要。结果表明充分关注接受者的情绪以及在告知坏消息后提供支持的必要性。

结论

接受者必须是各项程序的核心。有必要关注消息传达者的特点、消息内容以及最终的支持。实践意义:了解接受者、培训传达者并运用循证结果,改善告知坏消息的效果。

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本文引用的文献

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[The bad-news consultation: 10 tips].[坏消息告知会诊:十条建议]
Ned Tijdschr Geneeskd. 2019 Nov 28;163:D4134.
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Prevalence of Workplace Violence Types against Personnel of Emergency Medical Services in Iran: A Systematic Review and Meta-Analysis.伊朗针对紧急医疗服务人员的工作场所暴力类型的患病率:一项系统评价和荟萃分析。
Iran J Psychiatry. 2019 Oct;14(4):325-334.
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Breaking bad news about cancer in China: Concerns and conflicts faced by doctors deciding whether to inform patients.在中国告知癌症坏消息:医生在决定是否告知患者时面临的担忧和冲突。
Patient Educ Couns. 2020 Feb;103(2):286-291. doi: 10.1016/j.pec.2019.08.022. Epub 2019 Aug 17.
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The burden of not-weighted factors - Nursing workload in a medical Intensive Care Unit.非权重因素负担-医疗重症监护病房的护理工作量。
Intensive Crit Care Nurs. 2018 Aug;47:98-101. doi: 10.1016/j.iccn.2018.02.009. Epub 2018 Apr 2.
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Breaking bad news to antenatal patients with strategies to lessen the pain: a qualitative study.采用减轻痛苦策略向产前患者告知坏消息:一项定性研究
Reprod Health. 2018 Jan 23;15(1):11. doi: 10.1186/s12978-018-0454-2.
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Breaking bad news to patients with cancer: A randomized control trial of a brief communication skills training module incorporating the stories and preferences of actual patients.向癌症患者传达坏消息:一项简短沟通技巧培训模块的随机对照试验,该模块纳入了真实患者的故事和偏好。
Patient Educ Couns. 2017 Apr;100(4):655-666. doi: 10.1016/j.pec.2016.11.008. Epub 2016 Nov 13.
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Communication preferences of pediatric cancer patients: talking about prognosis and their future life.儿科癌症患者的沟通偏好:谈论预后及他们的未来生活
Support Care Cancer. 2017 Mar;25(3):769-774. doi: 10.1007/s00520-016-3458-x. Epub 2016 Oct 17.
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Speaking of Dying: A Practical Guide to Using Counselling Skills in Palliative Care Louis Heyse-Moore Speaking of Dying: A Practical Guide to Using Counselling Skills in Palliative Care Jessica Kingsley £17.99 192pp 9781843106784 1843106787 [Formula: see text].《谈论死亡:在姑息治疗中运用咨询技巧的实用指南》 路易斯·海斯 - 摩尔 《谈论死亡:在姑息治疗中运用咨询技巧的实用指南》 杰西卡·金斯利 17.99英镑 192页 9781843106784 1843106787 [公式:见正文]
Nurs Older People. 2009 Nov 24;21(10):12. doi: 10.7748/nop.21.10.12.s13.
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J Neurol Sci. 2016 Aug 15;367:368-74. doi: 10.1016/j.jns.2016.06.033. Epub 2016 Jun 16.
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The use of protocol in breaking bad news: evidence and ethos.在传达坏消息时使用规范流程:证据与理念。
Int J Palliat Nurs. 2016 Jun;22(6):265-71. doi: 10.12968/ijpn.2016.22.6.265.