Breaking Bad News 2: What Evidence Is Available to Guide Clinicians?
Walsh, Raoul A.
Sanson-Fisher, Rob W.
Behavioral Medicine. 1998 Summer; 24(2): 61-72.
Literature related to breaking bad news to medical patients was reviewed. An analysis of citations appearing between 1994 and August 1997 updated earlier work and indicated that a minority (24%) of the studies on the subject were designed to collect original data. Ten randomized controlled trials (RCTs) evaluating communication strategies with cancer patients in the diagnostic phase have been published since 1980. These RCTs were analyzed for methodological adequacy and their clinical implications. The sampling methods of the RCTs presented particular problems. Although patients liked the experimental interventions, there was little evidence of any effect on the patients' psychological adjustment; the effects on patients' knowledge and satisfaction levels were inconsistent. Healthcare consequences of issues concerned with patient selection, cultural factors, medical-legal requirements, and intervention costs are outlined and specific suggestions offered for future research testing the effects of different approaches to breaking bad news.
Cancer; Communication; Comprehension; Cultural Pluralism; Diagnosis; Disclosure; Empirical Research; Evaluation; International Aspects; Knowledge; Literature; Methods; Patient Satisfaction; Patients; Prognosis; Psychological Stress; Recall; Research; Research Design; Randomized Controlled Trials; Truth Disclosure;
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