Breaking Bad News for Patients with Gastro-Intestinal Malignancy: Experience at Ibn Sina Teaching Hospital

Abstract

Background: Integrity, beneficence, non-maleficence and Justice are the pillars of the professional behaviour. Confidentiality is a serious issue governed by the law. However, in developing countries, patients’ relatives urge to know the diagnosis and often request the doctor not to mention the word cancer or malignancy to their patient.
Objectives: To evaluate the communication skills for breaking bad news to Sudanese patients suffering of gastrointestinal cancer and to find out the patients’ responses on that matter.
Materials and Methods: This is a hospital based non-randomized  prospective study, carried out at Ibn Sina Specialized Hospital in the period August through December 2011. The study involved113 patients of whom there were 56 males.
Results: Doctors had talked about the disease to 75% of the patients  whereas the rest were told by either the psychologists and/or their  relatives. Only 25% of the patients were told the truth, the rest were told to have mass or lump without explaining its nature. Patients’ responses were as follows: 41.6% were felt terrified, 23.9% were shocked and became  anxious, while 33.6% were stable, but 0.9% became angry and frustrated. No patient was told about the prognosis and the chances of cure.
Conclusion: Sympathy over-ride empathy in communicating bad news to Sudanese patients suffering of cancer. Patient education and training in breaking the bad news is needed.

Key words: Communication skills, breaking bad news, truth telling, Sudan.