Assessment of Breaking Bad News Practice and Barriers Among Nurses and physician Working in Oncology unit at Tikur Anbessa specialized Hospital and st, Paul millinum Medical college, Addis Ababa, Ethiopia.
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Date
2018-06
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Addis Ababa University
Abstract
Background: Breaking bad news is a process of delivering news, which may negatively affect a patient’s and/or family’s view of the future. Globally breaking bad news is distressing to patients and families and is often uncomfortable for nurses or physicians on delivering it. In addition to the psychological impact of the news, breaking bad news also insensitively can cause patients additional distress and anecdotal accounts abound of the impact in relation to poor delivery.
Objectives: The aim of this study is to assess breaking bad news practice its barriers and associated factors among Physicians and nurses by using SPIKES protocol working at Tikur Anbessa specialized Hospital and St, Paul Millennium medical college oncology units, Addis Ababa, 2018.
Methods and analysis:Mixed approach quantitative and qualitative cross-sectional study design was conducted among physicians and nurses working in oncology units. Data was cleaned and entered using Epidata version 3.1 and analyzed using statically package for social sciences (SPSS), version 20. Descriptive statistics including frequency, proportions, mean and standard deviation was used to describe participant’s characteristics. Bivariate and multivariate analysis was carried out to see statistical association between
independent and the outcome variables. Qualitative data was triangulated and presented in the form of narration.
Result: The mean age of participants was 29.5 years (SD ± 6.6). Majority 128 (63.1%) were orthodox Christian followers and 148 (72.9%) were degree holders. Of all 82.85% participants were not attended any training related to breaking bad news practice, only 47.3% of the participants ever delivered bad news of whom, 7.9% of them used SPIKES protocol. Factors associated with breaking bad news practice include; marital status and training, {AOR=7.5; 95% CI (1.16-49.2)} p= 0.034, {AOR=12.5; 95% CI (1.7-27.6)p=
0.011} respectively. Lack of awareness of SPIKES protocol, time constraint, lack of separate room, work overload were the barriers identified by the in-depth interview.
Conclusion and Recommendation: In this study high prevalence of physicians, and nurses not used the SPIKES protocol for delivering breaking bad news. Marital status and having training are significantly associated with breaking bad news practice using SPIKES protocol. Lack of awareness of SPIKES protocol, time constraint, lack of separate room, work overload were barriers for reduced practice of breaking bad news practice using SPIKES protocol. Therefore, training for care providers, facility improvement, and development of standard guidelines are critically needed as that help to improve recommended breaking bad news practice at the mean time improve patient’s quality of life.
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breaking bad news, SPIKES protocol practice, barriers to use SPIKES.