title: The difficulties experienced by nurses and healthcare staff involved in the process of breaking bad news.
abstract: OBJECTIVE
  The aim of this study was to explore the difficulties experienced by nurses and healthcare professionals when engaging in the process of breaking bad news.
  
  
  BACKGROUND
  The challenges faced by staff when breaking bad news have previously been researched in relation to particular settings or participants. This study involved staff from diverse settings and roles to develop broader insights into the range of difficulties experienced in clinical practice.
  
  
  METHODS
  The study used a descriptive survey design involving self-reported written accounts and framework analysis.
  
  
  METHODS
  Data were collected using a structured questionnaire containing a free text section that asked participants to describe a difficult experience they had encountered when involved in the process of breaking bad news. Data were collected from healthcare staff from hospital, community, hospice and care home settings attending training days on breaking bad news between April 2011 and April 2014.
  
  
  RESULTS
  Multiple inter-related factors presented challenges to staff engaging in activities associated with breaking bad news. Traditional subjects such as diagnostic and treatment information were described but additional topics were identified such as the impact of illness and care at the end of life. A descriptive framework was developed that summarizes the factors that contribute to creating difficult experiences for staff when breaking bad news.
  
  
  CONCLUSIONS
  The framework provides insights into the scope of the challenges faced by staff when they engage in the process of breaking bad news. This provides the foundation for developing interventions to support staff that more closely matches their experiences in clinical practice.
authors.affiliation: Weston Park Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Clare
authors.identifier: http://orcid.org/0000-0002-8356-4199
authors.initials: C
authors.lastname: Warnock
authors.affiliation: Weston Park Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Jean
authors.initials: J
authors.lastname: Buchanan
authors.affiliation: School of Nursing and Midwifery, The University of Sheffield, UK.
authors.forename: Angela Mary
authors.initials: AM
authors.lastname: Tod
mesh_terms: D006282:Health Personnel; D006801:Humans; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires
keywords: allied health professionals; breaking bad news; communication; framework analysis; nurses; nursing; patient information