Improving bad news delivery for better patient outcomes

Anyone familiar with the work of Professor Samar Aoun (Perron Institute and La Trobe University) will know the importance she places on a person-centred approach at all stages of the disease trajectory and palliative care.

Steps to achieving this, specifically when breaking bad news are described in a contribution to a recently published clinical book entitled Neurologic and Neurodegenerative Diseases of the Larynx.

The chapter co-authored with psychologist, Associate Professor Lauren Breen of Curtin University, describes the term “breaking bad news” as the communication of any information that seriously and adversely affects the receiver’s expectations of the future, quality of life and availability of choices. Although examples included the communication of a serious diagnosis and prognosis for a number of life-limiting illnesses, the focus of the chapter was on motor neurone disease (MND).

According to co-authors Aoun and Breen, the delivery of the bad news of the MND diagnosis is one of the more stressful experiences of health professionals. Several studies have shown that medical and health professionals report the delivery of bad news to be a taxing experience, yet it is not given enough emphasis in their training.

Research indicates that receipt of bad news is often experienced as being without warmth or compassion, leaving patients and their family caregivers feeling shocked, confused, hopeless, angry and devastated.

However, say the co-authors of this chapter, skill in delivering bad news can be improved. They describe a six-step protocol to enhance the patient’s satisfaction with care, promote adjustment to the diagnosis and disease, and optimise wellbeing outcomes.

This chapter is based on a study led by Professor Aoun (President of the Motor Neurone Disease Association of WA) in 2015. A national survey of neurologists, patients and family carers was undertaken to find out how the diagnosis was delivered and received. Thirty-six per cent of the 248 patients who responded to the survey reported that they were not satisfied. Dr Rob Edis (Perron Institute consultant neurologist and Vice President of MNDAWA) was part of the research team.

The editors of the new book are Philip A. Weissbrod, Department of Surgery, University of California San Diego La Jolla and David O. Francis, Department of Surgery, University of Wisconsin–Madison in the USA.

Motor Neurone Disease Awareness Week starts this Sunday 3 May and ends Saturday 9 May 2020. See what is happening in your local area to support your local organisations and increase awareness.

Prof Samar Aoun Perron Institute

Professor Samar Aoun