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Breaking bad news

from Psychology, health and illness

Published online by Cambridge University Press:  18 December 2014

By
Katherine Joekes
Edited by
Susan Ayers ,
Andrew Baum ,
Chris McManus ,
Stanton Newman ,
Kenneth Wallston ,
John Weinman  and
Robert West
Katherine Joekes
Affiliation:
Leiden University
Susan Ayers
Affiliation:
University of Sussex
Andrew Baum
Affiliation:
University of Pittsburgh
Chris McManus
Affiliation:
St Mary's Hospital Medical School
Stanton Newman
Affiliation:
University College and Middlesex School of Medicine
Kenneth Wallston
Affiliation:
Vanderbilt University School of Nursing
John Weinman
Affiliation:
United Medical and Dental Schools of Guy's and St Thomas's
Robert West
Affiliation:
St George's Hospital Medical School, University of London
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Summary

What constitutes ‘bad news’

Many healthcare professionals will find themselves in a situation where they have to break bad or difficult news to patients and/or their relatives. A broad definition of what constitutes bad news includes situations where there is a threat to a person's mental or physical wellbeing, a risk of upsetting an established lifestyle, or where a message is given which conveys to an individual fewer choices in his or her life (Ptacek & Eberhardt, 1996). This indicates that bad news contains an element of loss or anticipated loss and will, to a certain extent, be subjective. Generally, news of death, terminal illness or deformity constitute the more extreme situations, and will generally be accepted as ‘bad news’ for the recipient. However, news of chronic illnesses or the need for medical intervention, which at first glance would appear less disastrous, could for the recipient have far-reaching or negative implications for their personal or working life, or their hopes for the future.

The breaking of bad news is stressful for both the messenger and the recipient. Because the manner in which bad news is given will impact the recipient and the decisions he or she needs to make (e.g. Roberts et al., 1994), there has been increased emphasis over the last decades on teaching appropriate communications skills to healthcare professionals. Factors that may create barriers to breaking bad news appropriately are outlined in this chapter, followed by general guidelines on how to break bad news.

Type
Chapter
Information
Cambridge Handbook of Psychology, Health and Medicine , pp. 423 - 426
Publisher: Cambridge University Press
Print publication year: 2007

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