Open Access Case Report

Breaking Bad News: Addressing Hope, Spiritual Needs, And Denial to Achieve High Value Care

Kushinga Bvute1*, Samantha I Caballero2 and Alexander J Young3

1Internal Medicine Residency Program, Florida Atlantic University, USA

2Charles E Schmidt College of Medicine, Florida Atlantic University, USA

3Charles E Schmidt College of Medicine, Florida Atlantic University, USA

Corresponding Author

Received Date: June 25, 2022;  Published Date:August 15, 2022

Abstract

Keywords:Bad news; Denial; Spiritual needs; Communication; High value care; Prognosis

Abbreviations:PCP: Primary Care Physician; CT: Computed Tomography; MRI: Magnetic Resonance Imaging

Introduction

Breaking bad news to a patient in the hospital is a powerful experience for doctors in training [1] and is widely regarded as a demanding task for physicians [2]. One challenge for the admitted patient is the frequent handoffs; one provider initiates the conversation about the disease and prognosis while a different physician may provide the follow-up. Additionally, inpatient providers lack pre-existing longitudinal relationships with their patients and insight into their values, cultural, spiritual, and social issues, or the family support system. Thus, preparation for these conversations inside the hospital is more complex [3].

When disclosing bad news, the quality of the communication significantly influences the patients’ emotional adjustment and compliance with recommendations [4]. In addition, patients’ belief in miracles or denial may hinder prognostic discussions [5]. With the high cost of healthcare, providers are expected to practice high value care by improving communication and incorporating patient concerns and values into care plans. This case illustrates the challenges of revealing bad news, examines the patient’s responses, and provides recommendations to better prepare physicians for disclosing bad news.

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