RESUMO
Communication challenges related to the delivery of bad news are present in oncologists' daily practice. Hence, communication skills are essential for clinicians to handle these situations as appropriately and compassionately as possible. The aim of this study was to identify Mexican oncologists' perceptions on the most important and hardest issues to discuss with patients and their families, as well as the challenges they most commonly encounter when communicating bad news. Physicians from various oncology centers were invited to anonymously complete an electronical survey designed by our multidisciplinary oncology team. Statistical analysis was performed with the SPSS software v25; descriptive statistics were used for the analysis of the survey's answers. In total, 115 physicians were included; most were medical oncologists. Treatment objectives and prognosis were the topics most of them considered relevant to address; while end-of-life care and treatment objectives were the hardest ones to discuss. The most difficult challenges they faced when breaking bad news were being honest without taking away hope and dealing with patients' emotions. Remarkably, we detected a lack of training in delivering bad news to patients among our participants, as a minority of them had formal training in the matter. However, most desired to receive communication skills training and believed a session of 2-5 h would be sufficient. Mexican oncologists face diverse communication challenges when disclosing bad news to patients. Our findings reveal an opportunity to develop formal training programs tailored for Mexican oncologists and to ultimately improve outcomes and patient-centered care.
Assuntos
Oncologistas , Relações Médico-Paciente , Comunicação , Humanos , México , Revelação da VerdadeRESUMO
A 16-year-old female patient showed up at the orthopaedics unit complaining of intolerable pain on her left hip. While being questioned and her clinical history written down, she shared that as part of her daily exercise routine, she ran 10 miles (16 km) daily at a speed of 9.5-10.5 mph (15-17 km/hour). MRI was consequently ordered, confirming the presence of a stress fracture. Therefore, immediate suspension of physical activity was indicated, followed by the prescription of crutches as well as restricted weight bearing. Gradually, she recovered complete functionality and approximately a month after she had entirely healed. While on a skiing trip, again she abruptly developed an acute pain on her right hip. Another MRI was ordered; its result confirmed a new stress fracture. Her previous treatment has proved so successful, a conservative approach was once again prescribed for her, showing optimum results 6 months later.