Al Zomia Ahmed Saad, AlHefdhi Hayfa A, Alqarni Abdulrhman Mohammed, Aljohani Abdullah K, Alshahrani Yazeed Sultan, Alnahdi Wejdan Abdullah, Algahtany Aws Mubarak, Youssef Naglaa, Ghazy Ramy Mohamed, Alqahtani Ali Abdullah, Deajim Mosab Abdulaziz
Faculty of Medicine, King Khalid University, Abha 62529, Saudi Arabia.
Department of Family Medicine, King Khalid University, Abha 62529, Saudi Arabia.
Healthcare (Basel). 2023 Sep 13;11(18):2528. doi: 10.3390/healthcare11182528.
Breaking bad news is an intrinsic aspect of physicians' clinical practices. This study aims to investigate how Saudi physicians manage the process of communicating bad news and explore potential differences in breaking bad news practices between young physicians (interns) and their older colleagues. From 1 March to 15 April 2023, ok an anonymous online cross-sectional survey was conducted to explore the communication practices of Saudi physicians concerning breaking bad news using the Communicating Bad News Questionnaire. The physicians were recruited through convenience and snowball sampling methods, and the survey questionnaire was distributed on various social media platforms, including Facebook, Twitter, LinkedIn, and WhatsApp. Data were analyzed using R version 4.2.1. A total of 782 physicians were included in this study. Male physicians represented 50.9% of the participants. Three-quarters (74.7%) were aged 25-30 years. The largest proportion of physicians (45.3%) were interns, followed by junior residents (22.9%), senior residents (11.0%), and specialists (6.5%). The median years of experience was 1.0, ranging from 0 to 45 years. Regarding the place of work, most physicians (86.6%) worked in hospitals, while 13.4% worked in primary healthcare centers. A total of 14.8% said they were not comfortable with discussing patients'/relatives' issues (20.60 among interns vs. 10.50% among non-interns, χ = 27.50, = 0.0001), 66.6% reported being trained to break bad news (59.60% among interns vs. 72.40% among non-interns, χ = 14.34, = 0.001), 59.1% reported breaking bad news to the patient, 37.9% reported to the family, and 3.1% reported to both, with no significant difference between interns and non-interns. A substantial proportion of physicians reported feeling uncomfortable discussing sensitive issues with patients and their relatives despite having received training to deliver bad news and being willing to communicate bad news directly to patients. Notably, our analysis identified a significant disparity between intern and non-intern physicians, particularly in terms of their comfort level in addressing patient-related concerns and access to breaking bad news training.
传达坏消息是医生临床实践的一个内在方面。本研究旨在调查沙特医生如何管理传达坏消息的过程,并探讨年轻医生(实习生)与其年长同事在传达坏消息实践中的潜在差异。2023年3月1日至4月15日,通过使用《传达坏消息问卷》进行了一项匿名在线横断面调查,以探究沙特医生在传达坏消息方面的沟通实践。医生通过便利抽样和滚雪球抽样方法招募,调查问卷在包括脸书、推特、领英和瓦次普等各种社交媒体平台上分发。使用R 4.2.1版本进行数据分析。本研究共纳入782名医生。男性医生占参与者的50.9%。四分之三(74.7%)的年龄在25至30岁之间。医生中比例最大的(45.3%)是实习生,其次是初级住院医师(22.9%)、高级住院医师(11.0%)和专科医生(6.5%)。经验年限中位数为1.0年,范围从0至45年。关于工作地点,大多数医生(86.6%)在医院工作,而13.4%在初级医疗保健中心工作。共有14.8%的人表示他们在讨论患者/亲属问题时感到不自在(实习生中为20.60%,非实习生中为10.50%,χ = 27.50,P = 0.0001),66.6%的人报告接受过传达坏消息的培训(实习生中为59.60%,非实习生中为72.40%,χ = 14.34,P = 0.001),59.1%的人报告向患者传达坏消息,37.9%的人报告向家属传达,3.1%的人报告向两者传达,实习生和非实习生之间无显著差异。相当一部分医生报告称,尽管接受过传达坏消息的培训且愿意直接向患者传达坏消息,但在与患者及其亲属讨论敏感问题时仍感到不自在。值得注意的是,我们的分析发现实习生和非实习生医生之间存在显著差异,特别是在处理与患者相关问题的舒适度以及获得传达坏消息培训方面。