José A Ferraz Gonçalves1, Carla Almeida2, Joana Amorim3, Rita Baltasar4, Joana Batista5, Yusianmar Borrero6, João Pedro Fallé7, Igor Faria8, Manuel Henriques9, Helena Maia10, Teresa Fernandes11, Mariana Moreira12, Susana Moreira13, Camila Neves14, Ana Ribeiro15, Ana Santos16, Filipa Silva17, Susana Soares18, Cristina Sousa19, Joana Vicente20, Rita Xavier21. 1. Portuguese Institute of Oncology, Palliative Care, Porto, Portugal. 2. Unidade de Saúde Familiar Famílias, Santa Maria da Feira, Portugal. 3. Unidade de Saúde Familiar Santa Clara, Póvoa de Varzim/Vila do Conde, Portugal. 4. Unidade de Saúde Familiar Santa Maria, Bragança, Portugal. 5. Unidade de Saúde Familiar Terras de Ferreira, Paços de Ferreira, Portugal. 6. Unidade de Saúde Familiar Lethes, Ponte de Lima, Portugal. 7. Unidade de Saúde Familiar Lagoa - Senhora da Hora, Matosinhos, Portugal. 8. Unidade de Saúde Familiar Gil Eanes, Viana do Castelo, Portugal. 9. Unidade de Saúde Familiar Ramalde, Aldoar, Porto, Portugal. 10. Unidade de Saúde Familiar Porta do Sol, Matosinhos, Portugal. 11. Unidade de Saúde Familiar Infesta, Matosinhos, Portugal. 12. Unidade de Saúde Familiar Mar, Póvoa de Varzim/Vila do Conde, Portugal. 13. Unidade de Saúde Familiar Arco do Prado, Gaia, Portugal. 14. Unidade de Saúde Familiar São Mamede Infesta, Matosinhos, Portugal. 15. Unidade de Saúde Familiar Oceanos, Matosinhos, Portugal. 16. Unidade de Saúde Familiar São João, Porto, Portugal. 17. Unidade de Saúde Familiar Nova Lousada, Lousada, Portugal. 18. Unidade de Saúde Familiar São Martinho, Penafiel, Portugal. 19. Unidade de Saúde Familiar Renascer, Gondomar, Portugal. 20. Unidade de Saúde Familiar Macedo de Cavaleiros, Macedo de Cavaleiros, Portugal. 21. Unidade de Saúde Familiar Aldoar, Porto, Portugal.
Abstract
HIGHLIGHTS: The attitudes of family physicians regarding breaking bad news are heterogeneous.Younger doctors seem to see the delivery of bad news more positively.This trend suggests that there will be a more open communication in the future. BACKGROUND: Family practice is the specialty with the highest number of doctors and covers all of Portugal, but, as far as we know, no studies have been carried out on the attitudes and practices of Portuguese family practice doctors about breaking bad news. However, the attitude of these doctors may have a high impact on patients. OBJECTIVE: To study the practice of family physicians on breaking bad news. METHODS: A questionnaire, specifically developed for this survey, was given to 196 doctors about 10% of the family physicians of Northern Portugal. RESULTS: One hundred fifty-nine (81%) of them participated in this study. The median age was 43 (26-64) and 108 (68%) of them were female. One hundred and seven (67%) doctors disclosed on principle the diagnosis and that rate rose to 81% when patients requested the disclosure. One hundred and two (64%) proactively questioned patients about their wish to know the diagnosis and then decided whether to convey it or not. Forty-seven 47 (30%) doctors disclosed the prognosis on principle and that rate rose to 48% when patients requested the disclosure. Seventy-three (46%) often questioned patients proactively about their wish to know the prognosis and then decided whether to convey it or not. One hundred and two (64%) doctors frequently include patients in treatment decisions. Physicians think that the disclosure may affect hope but may also give patients more control of the situation. CONCLUSION: Family practitioners disclose the diagnosis of a chronic life-threatening disease often, especially at patients' request. General practitioners do not disclose the prognosis of a life-threatening disease often, even at patients' request. Copyright 2017 PBJ-Associação Porto Biomedical/Porto Biomedical Society.
HIGHLIGHTS: The attitudes of family physicians regarding breaking bad news are heterogeneous.Younger doctors seem to see the delivery of bad news more positively.This trend suggests that there will be a more open communication in the future. BACKGROUND: Family practice is the specialty with the highest number of doctors and covers all of Portugal, but, as far as we know, no studies have been carried out on the attitudes and practices of Portuguese family practice doctors about breaking bad news. However, the attitude of these doctors may have a high impact on patients. OBJECTIVE: To study the practice of family physicians on breaking bad news. METHODS: A questionnaire, specifically developed for this survey, was given to 196 doctors about 10% of the family physicians of Northern Portugal. RESULTS: One hundred fifty-nine (81%) of them participated in this study. The median age was 43 (26-64) and 108 (68%) of them were female. One hundred and seven (67%) doctors disclosed on principle the diagnosis and that rate rose to 81% when patients requested the disclosure. One hundred and two (64%) proactively questioned patients about their wish to know the diagnosis and then decided whether to convey it or not. Forty-seven 47 (30%) doctors disclosed the prognosis on principle and that rate rose to 48% when patients requested the disclosure. Seventy-three (46%) often questioned patients proactively about their wish to know the prognosis and then decided whether to convey it or not. One hundred and two (64%) doctors frequently include patients in treatment decisions. Physicians think that the disclosure may affect hope but may also give patients more control of the situation. CONCLUSION: Family practitioners disclose the diagnosis of a chronic life-threatening disease often, especially at patients' request. General practitioners do not disclose the prognosis of a life-threatening disease often, even at patients' request. Copyright 2017 PBJ-Associação Porto Biomedical/Porto Biomedical Society.
Entities:
Keywords:
Diagnosis disclosure; Family practitioners; Prognosis disclosure; Treatment decisions
Authors: Karen Hancock; Josephine M Clayton; Sharon M Parker; Sharon Wal der; Phyllis N Butow; Sue Carrick; David Currow; Davina Ghersi; Paul Glare; Rebecca Hagerty; Martin H N Tattersall Journal: Palliat Med Date: 2007-09 Impact factor: 4.762