Breaking bad news in stroke rehabilitation: a consultation with a community stroke team.
OBJECTIVE
Within stroke care clinicians are frequently required to break bad news to patients, however, formal training and guidance remains limited. This article provides a case example of a multidisciplinary stroke rehabilitation team consultation, and aims to contribute towards an evidence base and a model of training for breaking bad news (BBN) in stroke care.


METHODS
The stroke rehabilitation team requested clinical psychology consultation to help with difficulties they were experiencing in BBN to patients. The consultation comprised an assessment of the request, development of a proposal, delivery of a workshop on BBN and an evaluation of consultation impact. A collaborative consultation model underpinned the work, which aimed to empower and facilitate the team to generate solutions by drawing upon their existing expertise.


RESULTS
The consultation was found to meet the team's expectations and needs. Consultees reported increased confidence to communicate difficult messages to patients and rated the consultation highly. A follow-up review indicated the consultation had led to changes in practice.


CONCLUSIONS
Communication skills are central to BBN effectively. Clinicians may be supported to recognize their existing skill set and increase confidence in their ability to break bad news through a process of collaborative team consultation.
Department of Psychology, University of Surrey, Guildford, UK. joanna.phillips4@nhs.net
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D003142:Communication; D006801:Humans; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D010817:Physician-Patient Relations; D015397:Program Evaluation; D012017:Referral and Consultation; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D014342:Truth Disclosure