Delivering difficult news. Views of mental health staff in inpatient settings.
In this study, we surveyed clinical staff to ascertain their views regarding the delivery of difficult news (DDN), such as the need for lifelong medication with possible side effects, in inpatient mental health settings. Nearly all staff agreed patients had a right to information about their diagnosis, two thirds thought the doctor was the best person to inform patients of their diagnosis, and approximately half believed full diagnosis and treatment disclosure may have negative consequences. Providing hope when delivering difficult news was endorsed by almost all staff, and most took special precautions (e.g., greater monitoring) after DDN. Two thirds had never received specific training for DDN, yet most considered themselves competent in DDN. In DDN, staff usually or always considered patients' level of insight/awareness, likely distress, diagnosis, and whether they would understand the consequences of the diagnosis.
Cleary
Michelle
M
Mental Health Nursing, School of Nursing and Midwifery, University of Western Sydney, and Sydney West Area Mental Health Service, Concord Hospital, New South Wales, Australia. M.cleary@uws.edu.au
Hunt
Glenn E
GE
Walter
Garry
G
D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003625:Data Collection; D003704:Dementia / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology*; D009723:Nurse-Patient Relations; D010353:Patient Education as Topic / Q000379:methods*; D011368:Professional-Family Relations; D011379:Prognosis; D014342:Truth Disclosure