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Medline ® Abstract for Reference 21

of 'Discussing serious news'

Concerns about losing control when breaking bad news to terminally ill patients with cancer: physicians' perspective.
Friedrichsen M, Milberg A
J Palliat Med. 2006 Jun;9(3):673-82.
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.
Unit of Advanced Palliative Home Care/Linnea, Vrinnevi Hospital, Department of Welfare and Care-Palliative Care, Linköping University, Norrköping, Sweden. marfr@ivv.liu.se