Presented by

Dr. Katherine Miles

Breaking Bad News: Experience and Preferences of Patients, Relatives and Doctors in Jordan

Dr. Katherine Miles, Dr. Abdel-Ellah Al-Shudifat, Dr. Stella Howden

Hashemite University

katemiles@doctors.org.uk

Objective:

This study aimed to explore doctors, patients’ and relatives’ experiences of breaking bad news and to consider the implications for medical education and training in the Jordanian context.

Methods:

A cross-sectional survey design, using questionnaires was used to address the study aims. Questionnaires were completed by: patients (n=59), relatives (n=50) and doctors (n=161).

Results:

Only 25.4% of patients reported receiving their diagnosis according to their preference. There was a statistically significant disparity regarding patients’ and relatives’ preferences for first disclosure. Doctors reported that their greatest challenge was that often relatives did not want the patient to know the diagnosis. The study highlighted doctors’ training needs including: how to use religious phrases, physical touch, and how to manage initial reactions of patients and/or relatives.

Conclusion:

The Calgary-Cambridge Framework would appear to be an applicable framework for the Jordanian context, and would be augmented when considered in tandem with existing culturally cognizant frameworks, for example, the IGAD Framework. The findings may be applicable beyond Jordan when breaking bad news to patients and relatives with a Middle Eastern background.

Practice Implications:

There is a need to identify and understand specific cultural considerations when developing breaking bad news curricula.