Maria Friedrichsen1, Anna Milberg. 1. Unit of Advanced Palliative Home Care/Linnea, Vrinnevi Hospital, Department of Welfare and Care-Palliative Care, Linköping University, Norrköping, Sweden. marfr@ivv.liu.se
Abstract
OBJECTIVE: To study and explore problems perceived by physicians when breaking bad news to advanced cancer patients about discontinuing or not offering tumor-specific treatment due to incurable cancer. DESIGN: A qualitative phenomenographic interview study. SETTING: The county of Ostergötland in Sweden. PARTICIPANTS: Thirty physicians with different demographic characteristics. RESULTS: According to the physicians' answers breaking bad news was perceived as involving a risk of losing control in different ways, regarding emotions, oneself, confidence, professionalism and patient trust. Four different main categories described as problems were identified; perceptions focusing on existential thoughts, relationships, knowledge, and perceptions related to time and environmental disturbances. CONCLUSION: Physicians perceived that breaking bad news to dying patients with cancer involved a risk of losing control. Existential thoughts and a lack of knowledge contribute to this risk. Theoretical education in existentiality/spirituality and clinical practice in a palliative context may help maintaining control.
OBJECTIVE: To study and explore problems perceived by physicians when breaking bad news to advanced cancerpatients about discontinuing or not offering tumor-specific treatment due to incurable cancer. DESIGN: A qualitative phenomenographic interview study. SETTING: The county of Ostergötland in Sweden. PARTICIPANTS: Thirty physicians with different demographic characteristics. RESULTS: According to the physicians' answers breaking bad news was perceived as involving a risk of losing control in different ways, regarding emotions, oneself, confidence, professionalism and patient trust. Four different main categories described as problems were identified; perceptions focusing on existential thoughts, relationships, knowledge, and perceptions related to time and environmental disturbances. CONCLUSION: Physicians perceived that breaking bad news to dying patients with cancer involved a risk of losing control. Existential thoughts and a lack of knowledge contribute to this risk. Theoretical education in existentiality/spirituality and clinical practice in a palliative context may help maintaining control.
Authors: Rachel A Rodenbach; Kim Brandes; Kevin Fiscella; Richard L Kravitz; Phyllis N Butow; Adam Walczak; Paul R Duberstein; Peter Sullivan; Beth Hoh; Guibo Xing; Sandy Plumb; Ronald M Epstein Journal: J Clin Oncol Date: 2017-01-30 Impact factor: 44.544