Yousuf Abdulla Ahmad A A, Stewart Derek Charles, Kane Tanya, Soltani Abderrezzaq, Al-Khal Abdullatif, Sethi Ahsan
QU Health, Qatar University, Doha, Qatar.
Hamad Medical Corporation, Doha, Qatar.
Front Med (Lausanne). 2024 Sep 3;11:1440867. doi: 10.3389/fmed.2024.1440867. eCollection 2024.
Breaking bad news is a critical yet challenging aspect of healthcare that requires effective communication skills, empathy, and cultural sensitivity. Health professionals in the World Health Organization's (WHO) Eastern Mediterranean Region face unique cultural and social factors distinct from other parts of the world. This scoping review aims to comprehensively explore the peer-reviewed literature on the health professionals' experiences in delivering bad news within the WHO's Eastern Mediterranean Region.
This scoping review was conducted according to the Joanna Brigg Institute's scoping review methodology and reported utilizing the Preferred Reporting Items for Systematic Reviews extension for scoping review (PRISMA-ScR) guidelines. A search using a combination of keywords and MeSH terms related to "breaking bad news" and "health professionals" was performed in PubMed, Scopus, CINAHL, EBSCO, ERIC via Embase, and Dar Almandumah (Arabic) databases. Common themes were synthesized from studies conducted in the WHO's Eastern Mediterranean Region.
Out of 4,883 studies initially identified in the databases, 24 studies met the inclusion criteria, involving a total of 4,710 participants, including physicians, nurses, and residents. The studies were published between 2006 and 2022, predominantly from Iran ( = 12). The majority employed a cross-sectional design ( = 21) or mixed methods ( = 3), with a notable absence of qualitative studies. No studies used theoretical frameworks. More than half of the studies ( = 14) reported that participants had positive attitudes toward breaking bad news. This positivity was evident in their willingness to share bad news, perceived possession of adequate knowledge, positive attitudes, having received training, awareness of accepted approaches, and adherence to protocols. The lack of training and limited awareness of established protocols like SPIKES, ABCDE, and BREAKS for breaking bad news were major concerns among participants.
The scoping review reveals both positive and negative experiences of breaking bad news by health professionals in the WHO's Eastern Mediterranean Region. Most studies highlight the need for culturally sensitive targeted education and training programs on breaking bad news. Further research, particularly using qualitative methodologies and theoretical frameworks is warranted.
传达坏消息是医疗保健中一个关键但具有挑战性的方面，需要有效的沟通技巧、同理心和文化敏感性。世界卫生组织（WHO）东地中海区域的卫生专业人员面临着与世界其他地区不同的独特文化和社会因素。本范围综述旨在全面探索关于卫生专业人员在WHO东地中海区域传递坏消息经历的同行评议文献。
本范围综述按照乔安娜·布里格斯研究所的范围综述方法进行，并根据系统评价扩展版的首选报告项目（PRISMA-ScR）指南进行报告。通过在PubMed、Scopus、CINAHL、EBSCO、通过Embase检索的ERIC以及Dar Almandumah（阿拉伯语）数据库中，使用与“传达坏消息”和“卫生专业人员”相关的关键词和医学主题词进行搜索。从在WHO东地中海区域开展的研究中综合提炼出共同主题。
在数据库中最初识别出的4883项研究中，24项研究符合纳入标准，共涉及4710名参与者，包括医生、护士和住院医师。这些研究发表于2006年至2022年之间，主要来自伊朗（n = 12）。大多数研究采用横断面设计（n = 21）或混合方法（n = 3），明显缺乏定性研究。没有研究使用理论框架。超过一半的研究（n = 14）报告称参与者对传达坏消息持积极态度。这种积极性体现在他们愿意分享坏消息、认为自己具备足够的知识、持积极态度、接受过培训、了解公认的方法以及遵守规程方面。参与者主要担心缺乏传达坏消息的培训以及对SPIKES、ABCDE和BREAKS等既定规程的认识有限。
该范围综述揭示了WHO东地中海区域卫生专业人员在传达坏消息方面的积极和消极经历。大多数研究强调需要开展关于传达坏消息的具有文化敏感性的针对性教育和培训项目。有必要进行进一步研究，特别是采用定性方法和理论框架的研究。
