title: Breaking bad news: patients' preferences and health locus of control.
abstract: OBJECTIVE
  To identify patients' preferences for models of communicating bad news and to explore how such preferences, and the reasons for the preferences, relate with personality characteristics, specifically patients' health locus of control (HLC): internal/external and 'powerful others' (PO).
  
  
  METHODS
  Seventy-two patients from an oncology clinic watched videotaped scenarios of a breaking bad news moment, selected the model they preferred, filled an HLC scale and were interviewed about their choices. Data were analyzed with Chi-square, Kruskal-Wallis and Mann-Whitney tests. Interviews were content-analyzed.
  
  
  RESULTS
  77.8% preferred an "empathic professional", 12.5% a "distanced expert" and 9.7% an "emotionally burdened expert". Preferences varied significantly with HLC scores (patients with higher internal locus of control (ILC) and lower PO preferred the empathic model), presence of cancer, age and education. Patients explained their preferences through aspects of Caring, Professionalism, Wording, Time and Hope. ILC registered significant differences in regards to Wording and Time, whereas PO was associated with Hope and Time.
  
  
  CONCLUSIONS
  HLC is an important dimension that can help doctors to better know their patients.
  
  
  CONCLUSIONS
  Knowing whether patients attribute their health to their own behaviors or to chance/others can help tailor the disclosure of bad news to their specific preferences.
authors.affiliation: Department of Clinical Neurosciences and Mental Health, School of Medicine, University of Oporto, Portugal. martins.raquel@hotmail.com
authors.forename: Raquel Gomes
authors.initials: RG
authors.lastname: Martins
authors.forename: Irene Palmares
authors.initials: IP
authors.lastname: Carvalho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003142:Communication; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D057240:Patient Preference / Q000523:psychology*; D010551:Personality; D010817:Physician-Patient Relations; D011209:Power, Psychological; D014342:Truth Disclosure; D055815:Young Adult