title: Communication strategies and cultural issues in the delivery of bad news.
abstract: Good communication is a fundamental skill for all palliative care clinicians. Patients present with varied desires, beliefs, and cultural practices, and navigating these issues presents clinicians with unique challenges. This article provides an overview of the evidence for communication strategies in delivering bad news and discussing advance care planning. In addition, it reviews the literature regarding cultural aspects of care for terminally ill patients and their families and offers strategies for engaging them. Through good communication practices, clinicians can help to avoid conflict and understand patients' desires for end of life care.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27705-3860, USA. barc1004@mc.duke.edu
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Barclay
authors.forename: Leslie J
authors.initials: LJ
authors.lastname: Blackhall
authors.forename: James A
authors.initials: JA
authors.lastname: Tulsky
mesh_terms: D032722:Advance Care Planning; D003142:Communication; D018864:Cultural Diversity; D003657:Decision Making; D006801:Humans; D011369:Professional-Patient Relations; D019452:Terminally Ill; D014342:Truth Disclosure