Department of Family Medicine & Public Health, Sultan Qaboos University Hospital, University Medical City, Muscat, Oman.
College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
Sultan Qaboos Univ Med J. 2024 Aug;24(3):345-353. doi: 10.18295/squmj.3.2024.021. Epub 2024 Aug 29.
This study aimed to investigate the knowledge, attitude and experiences in sharing unpleasant health information and adherence to the SPIKES protocol among physicians at a tertiary hospital in Muscat, Oman.
This cross-sectional study was conducted at the Sultan Qaboos University Hospital from August to October 2022. An electronic, self-administered questionnaire was used to gather data from physicians across various departments.
A total of 89 physicians completed the questionnaire (response rate = 22.3%). Most participants (n = 86, 96.6%) recognised the need for additional training in the delivery of unpleasant health information ('bad news'), with 78.7% (n = 70) expressing their willingness to undertake such training. Additionally, 32.6% (n = 29) reported negative experiences due to improper delivery of bad news, with an equal proportion admitting to disclosing bad news to patients' family without their consent. The majority (n = 77, 86.5%) demonstrated a high level of overall adherence to the SPIKES protocol, with 59.6-85.4%, 12.4-34.8% and 1.1-11.2% reported usually, sometimes and never following specific steps of the protocol, respectively. Marital status ( = 0.015) and qualifications ( = 0.032) were the only variables that were associated with adherence level, with married physicians and those with board and/or fellowship certificates reporting significantly better adherence compared to their counterparts.
Physicians in Oman encounter challenges in delivering unpleasant health information, underscoring the interplay of cultural influences, training and adherence to protocols. To address these challenges, targeted and frequent training programmes are recommended, starting from undergraduate medical education and extending to continuous opportunities for physicians at various career levels.
本研究旨在调查阿曼马斯喀特一家三级医院的医生在分享不愉快的健康信息方面的知识、态度和经验，以及他们对 SPIKES 方案的遵循情况。
这项横断面研究于 2022 年 8 月至 10 月在苏丹卡布斯大学医院进行。采用电子自填式问卷，从各个科室的医生那里收集数据。
共有 89 名医生完成了问卷（应答率=22.3%）。大多数参与者（n=86，96.6%）认识到在传递不愉快的健康信息（“坏消息”）方面需要额外的培训，其中 78.7%（n=70）表示愿意接受此类培训。此外，32.6%（n=29）报告由于不当传递坏消息而导致负面体验，同样比例的医生承认在未经患者家属同意的情况下向其透露坏消息。大多数医生（n=77，86.5%）对 SPIKES 方案总体遵循程度较高，分别有 59.6-85.4%、12.4-34.8%和 1.1-11.2%的医生通常、有时和从不遵循方案的具体步骤。婚姻状况（ = 0.015）和资格（ = 0.032）是唯一与遵循水平相关的变量，已婚医生和具有委员会和/或研究员证书的医生比他们的同行报告有显著更好的遵循水平。
阿曼的医生在传递不愉快的健康信息方面面临挑战，这突显了文化影响、培训和遵循方案之间的相互作用。为了应对这些挑战，建议开展有针对性的、频繁的培训计划，从医学本科教育开始，并为各级医生提供持续的机会。
