title: Breaking the news of a diagnosis of motor neurone disease: A national survey of neurologists' perspectives.
abstract: Communication of the diagnosis of MND is daunting for patients and neurologists. This study aimed to establish a knowledge base of current Australian practice of breaking the news of an MND diagnosis, to assess the neurologists' educational and training needs and to compare the feedback obtained from neurologists and patients to international practice guidelines. An anonymous survey of neurologists was undertaken in Australia (2014). 73 neurologists responded to this national survey (50.4% response rate). Nearly 70% of neurologists reported finding it "somewhat to very difficult" communicating the MND diagnosis, and 65% reported feeling moderate to high stress and anxiety at the delivery of diagnosis. Compared to international guidelines, areas for improvement include length of consultation, period of follow up and referral to MND associations. Two-thirds of neurologists were interested in further training to respond to patient's emotions and development of best practice guidelines. This is the first national study to provide a comprehensive insight into the process of delivering the MND diagnosis from the neurologists' perspective and to make comparisons with those of patients and the international guidelines. This study forms the basis for developing protocols to improve communication skills and alleviate the emotional burden associated with breaking bad news.
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Australia. Electronic address: s.aoun@curtin.edu.au.
authors.forename: Samar M
authors.initials: SM
authors.lastname: Aoun
authors.affiliation: School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Australia. Electronic address: Lauren.Breen@curtin.edu.au.
authors.forename: Lauren J
authors.initials: LJ
authors.lastname: Breen
authors.affiliation: Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia. Electronic address: robedis@it.net.au.
authors.forename: Robert
authors.initials: R
authors.lastname: Edis
authors.affiliation: Royal Brisbane & Women's Hospital, Butterfield Street, Herston, Queensland 4006, Australia. Electronic address: Robert.Henderson@health.qld.gov.au.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Henderson
authors.affiliation: Wisdom Hospice, High Bank, Rochester, Kent ME1 2NU, UK; University of Kent, UK. Electronic address: DRDJOLIVER@GMAIL.COM.
authors.forename: David
authors.initials: D
authors.lastname: Oliver
authors.affiliation: MND Victoria, PO Box 23, Canterbury, Victoria 3126, Australia. Electronic address: rharris@mnd.asn.au.
authors.forename: Rodney
authors.initials: R
authors.lastname: Harris
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Australia. Electronic address: denise.howting@curtin.edu.au.
authors.forename: Denise
authors.initials: D
authors.lastname: Howting
authors.affiliation: Faculty of Health, Arts & Design, Swinburne University Melbourne, Victoria 3800, Australia. Electronic address: margaret.oconnor@monash.edu.
authors.forename: Margaret
authors.initials: M
authors.lastname: O'Connor
authors.affiliation: MND Australia, PO Box 990, Gladesville, NSW 1675, Australia. Electronic address: carolb@mndaust.asn.au.
authors.forename: Carol
authors.initials: C
authors.lastname: Birks
mesh_terms: D001291:Attitude of Health Personnel; D001315:Australia; D004645:Empathy; D005190:Family / Q000523:psychology; D030141:Feedback, Psychological; D005260:Female; D058015:Health Communication / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000175:diagnosis* / Q000523:psychology*; D000072141:Neurologists / Q000193:education / Q000523:psychology*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
keywords: Best practice protocols; Breaking bad news; Education; Empathy; MND diagnosis; MND multidisciplinary clinics; MND/ALS; Training