EXPERIENCES OF CLINICIANS IN BREAKING BAD NEWS: A QUALITATIVE STUDY AT AIC KIJABE HOSPITAL

Abstract

Breaking bad news is a daunting task that clinicians encounter quite frequently in practice. It takes a wide range of clinical scenarios. The process of breaking bad news has the potential to enhance the therapeutic relationship with improved outcomes for both patient and provider. Conversely, it can have a deleterious effect on both parties medically, psychologically, socially, and even legally through litigation. Providers have different experiences when breaking such bad news. These experiences vary depending on a wide range of aspects that could be categorized into three: environmental, patient-related, and provider-related aspects. Some aspects are modifiable while others are not. This study sought to explore the experiences of clinicians in breaking bad news and how they can be supported. This qualitative study was conducted in AIC Kijabe Hospital, a Level V teaching, faith-based hospital. The study population was clinical and medical officers across four cadres. It was conducted using focus group discussions with the use of a semi-structured interview guide. Inductive coding was done, and the report was done in narrative form with the use of graphics where appropriate. It was found that clinicians often share their experiences with those they consider part of their support system. The experience of delivering bad news varies among clinicians, and many admit that they do not feel adequately prepared for this task. Different aspects affect clinicians in different ways. Emerging areas such as the impact of dual relationships, spirituality, and stacking in breaking bad news need further research. Strategies for maintaining emotional and psychological well-being exist at various levels, including individual, team, and institutional levels. Clinicians have adopted both healthy and unhealthy coping mechanisms. Institutional support includes policies, training, logistical support, and psychological assistance.