Doctors' attitudes in the situation of delivering bad news: patients' experience and expectations

Abstract

Introduction: The purpose of our research was to find out patients' preferences concerning their doctors' attitudes and behaviour as they deliver bad news to them. Material and methods: In national research conducted from February to October 2017 using the computer-assisted web interview (CAWI) technique, we studied the statements of 314 adult patients who had received bad medical news from their doctors. Seventy-nine per cent of them were women and 21% were men. Fifty-nine per cent had higher education and 33% had secondary education. A specially designed closed question survey was used as a tool to collect the data. Results: Most of the patients (59.6%) expected a doctor-patient relationship based on partnership and collective decisions concerning further treatment. Patients wanted their doctors to be honest with them, to provide them with solid information and an opportunity to ask questions and discuss the suggested solutions. Less than 2 out of 10 patients expected "an empathy specialist". The patients who evaluated their doctors' behaviour and the way bad news was delivered to them negatively were more likely to change doctors or terminate their treatment. Conclusions: The doctor-patient relationship when an unfavourable diagnosis is being communicated is an important aspect, which defines the way people who participate in this difficult situation behave and communicate. Doctors' behaviour during DBN should meet the patients' expectations. Such an attitude guarantees trust towards doctors and results in more positive evaluations on them. Most importantly, it translates directly into the patients' therapeutic behaviours and treatment effects.