Cancer patients’ experiences and preferences when receiving bad news: a qualitative study

Purpose Receiving a cancer diagnosis significantly impacts patients’ lives, and how the bad news is delivered influences patients’ trajectory, psychosocial adjustment and openness to psycho-oncological support. We explored how patients’ experiences, reactions and preferences were when receiving the...

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Bibliographic Details
Published in:Journal of cancer research and clinical oncology Vol. 149; no. 7; pp. 3859 - 3870
Main Authors: Krieger, Theresia, Salm, Sandra, Dresen, Antje, Cecon, Natalia
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2023
Springer Nature B.V
Subjects:
Cancer
Cancer Research
Communication
Diagnosis
fearfulness
Female
females
Hematology
Humans
Internal Medicine
Male
Medicine
Medicine & Public Health
Middle Aged
neoplasms
Neoplasms - psychology
Oncology
Patient Preference
Physician-Patient Relations
qualitative analysis
Qualitative research
telephones
Truth Disclosure
Patient preferences
Qualitative research
Patient experiences
Receiving bad news
Physician–patient communication
Cancer
ISSN:0171-5216, 1432-1335, 1432-1335
Online Access:Get full text
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Summary:Purpose Receiving a cancer diagnosis significantly impacts patients’ lives, and how the bad news is delivered influences patients’ trajectory, psychosocial adjustment and openness to psycho-oncological support. We explored how patients’ experiences, reactions and preferences were when receiving the news and which optimization recommendations can be made. Methods We conducted an exploratory qualitative study with patients who enrolled in the new integrated cross-sectoral psycho-oncological care programme ‘isPO’, being enrolled 12 months post-diagnosis. Data on the main issue (i.e. perception of the moment when the diagnosis is received) were collected via telephone interviews that were fully audiotaped and transcribed. Two independent coders conducted inductive content analyses using MAXQDA. Results Out of 38 approached patients, 23 cancer patients with 13 different tumour entities participated. They had a mean age of 54.2 (SD 16.2); n  = 17 (74%) were female. Three major themes with 14 corresponding subthemes emerged: (1) patients’ experiences with the bad news delivery, including setting, mode, preparation and perceived needs; (2) patients’ reactions to the bad news, such as shock, fear and helplessness, disbelief and denial, anger and feeling of injustice, thankfulness and depression; and (3) patients’ receiving preferences, including psycho-oncological support, addressing informational needs, needs-driven comprehensive support and a competent multidisciplinary support team. Conclusions The quality of bad news delivery and addressing patients’ needs should be strongly considered by physicians. We recommend integrating patients’ perspective on the quality management processes of breaking bad news. For providing needs-centred high-quality care, applying existing guidelines and acquiring patient-centred communication skills are central.
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ISSN:0171-5216
1432-1335
1432-1335
DOI:10.1007/s00432-022-04311-8