Breaking Bad News Knowledge and Attitude of Junior Physician Practicing at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
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Date
2021-12
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Addis Abeba University
Abstract
Introduction: Breaking bad news to patients or discussing a serious case with a patient is part of
the daily activity of many healthcare professionals and it is an inevitable clinical duty. In a
Medical setting bad news is any information likely to alter drastically a patient's view of his or
her future perspectives and vision of life. Effective communication skills of delivering bad news
are very important to develop good patient-physician relationships.
Objective; To assess the Knowledge, and Attitude of TASH Junior physicians about breaking
bad news.
Methods: An institutional-based cross-sectional study at Tikur Anbessa specialized hospital,
Addis Ababa Ethiopia from August to October 2021, and comprised 286 postgraduate residents
of different specialties making a 98% response rate. Their knowledge and attitude were assessed
by using a specifically-designed questionnaire based on SPIKES protocol. It is a six-step
protocol of Setting, Perception, Invitation, Knowledge, Empathy, and Summarizing model. Data
were collected through self-administered questionnaires and online surveys. The collected data
were entered into Microsoft excel, then it was exported to SPSS of version 26.0 for analysis.
Bivariate and multivariate analysis using logistic regression models was used to determine the
association between different predictor variables with the dependent variable
Results: Among 286 respondents, 201 (70.3%) were males and 85(29.7) were females and the
mean age of the participants was 29.69 years (SD±2.205) years).98.3% of participants have been
involved in breaking bad news, (37.1%) admitted bad experience in breaking bad news and
87.6% did not have any specific teaching or training on BBN. The mean and median score of the
participants' knowledge about breaking bad news in this study was 5.94 (SD ± 1.100) and 6
respectively. Among participants, 70.3% had good knowledge, followed by a poor knowledge
(16.4%) and a Moderate level of knowledge (13.3%). From self-reported breaking bad news
skills majority of participants (57.7%) of participants were only fairly satisfied with their BBN
skills.
Conclusion
Most of the participating physicians didn’t receive any training on BBN, a substantial number of
residents didn't follow BBN protocol. Even though a majority of participants had good
knowledge they had little satisfaction regarding their BBN skills
Recommendation
Education and training for trainees during their residency programs to improve their BBN skills
should be considered and adoption of BBN protocol
Description
Keywords
Breaking bad news, SPIKES protocol, TASH