title: Doctors' Perceptions and Practices of Breaking Bad News: A Qualitative Study From Greece.
abstract: There is limited information about doctors' communication behaviors and their salient beliefs with regard to bad news disclosure in Greece. In this qualitative study we investigated the self-reported practices of doctors on breaking bad news, their perceptions about the factors affecting the delivery of such news, and their beliefs about the most appropriate disclosure manner. A focus group discussion and individual interviews were conducted. Twenty-five resident and specialist doctors from primary health care and hospital settings participated. We analyzed the collected data with content analysis techniques. Participants were found to acknowledge the importance of appropriate and effective delivery of bad news; however, none of them reported the implementation of empirically informed communication practices. They described communication patterns mainly formed by their work experience and often guided by the patient's family requests. Doctor, patient, and family characteristics and organizational features and resources were reported to affect the delivery of bad news. Participants perceived the most appropriate disclosure manner as an individualized approach to each patient's unique needs. They suggested an interdisciplinary, collaborative management of the delivery process and the establishment of formal supportive services. These findings may provide useful information for the development of tailored, empirically informed curriculum interventions and educational programs in order to address several barriers to communication. Sociocultural characteristics that influence the disclosure practice, as well as physicians' perceptions that are consistent with the optimal information delivery, should be taken into account. System-level strategies that focus on the development of patient-centered communication also need to be prioritized.
authors.affiliation: a Department of Hygiene, Epidemiology and Medical Statistics , University of Athens Medical School.
authors.forename: Despoina
authors.initials: D
authors.lastname: Oikonomidou
authors.affiliation: b Department of Psychology , Panteion University of Social and Political Sciences.
authors.forename: Fotios
authors.initials: F
authors.lastname: Anagnostopoulos
authors.affiliation: a Department of Hygiene, Epidemiology and Medical Statistics , University of Athens Medical School.
authors.forename: Christine
authors.initials: C
authors.lastname: Dimitrakaki
authors.affiliation: c First Department of Psychiatry, Eginition Hospital , University of Athens Medical School.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Ploumpidis
authors.affiliation: b Department of Psychology , Panteion University of Social and Political Sciences.
authors.forename: Stylianos
authors.initials: S
authors.lastname: Stylianidis
authors.affiliation: a Department of Hygiene, Epidemiology and Medical Statistics , University of Athens Medical School.
authors.forename: Yannis
authors.initials: Y
authors.lastname: Tountas
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005190:Family / Q000523:psychology; D005260:Female; D017144:Focus Groups; D006115:Greece; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D036301:Qualitative Research; D014342:Truth Disclosure