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.
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Levit EL, Balogh E, Nass S, et al. “Patient-Centered Communication and Shared Decision Making,” in Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population; Board on Health Care Services
Kissane DW et al. (2012) “Communication skills training for oncology professionals,” J Clin Oncol
Gilligan T, Coyle N, Frankel RM, Berry DL, Bohlke K, Epstein RM, Finlay E, Jackson VA, Lathan CS, Loprinzi CL, Nguyen LH, Seigel C, Baile WF (2017) Patient-clinician communication: American society of clinical oncology consensus guideline. J Clin Oncol 35(31):3618–3632
Min JW, Barrio C (2009) Cultural values and caregiver preference for Mexican-American and non-Latino white elders. J Cross Cult Gerontol 24(3):225–239
Torrecillas L (1997) Communication of the cancer diagnosis to mexican patients. Ann N Y Acad Sci 809(1 Communication):188–196
Gebhardt C, Gorba C, Oechsle K, Vehling S, Koch U, A Mehnert (2017) “Die Kommunikation schlechter Nachrichten bei Krebspatienten: Inhalte, Kommunikationspräferenzen und psychische Belastungen. [breaking bad news to cancer patients: content, communication preferences and psychological distress.],” PPmP: Psychotherapie Psychosomatik Medizinische Psychologie
Stewart MA (1995) “Effective physician-patient communication and health outcomes: A review,” CMAJ
Barth J, Lannen P (2011) “Efficacy of communication skills training courses in oncology: a systematic review and meta-analysis,” Ann Oncol
Karger A, Geiser F, Vitinius F, Sonntag B, Schultheis U, Hey B, Radbruch L, Ernstmann N, Petermann-Meyer A (2017) Communication skills trainings: subjective appraisal of physicians from five cancer centres in North Rhine, Germany. Oncol Res Treat 40(9):496–501
Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP (2000) SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist 5(4):302–311
Fujimori M, Shirai Y, Asai M, Kubota K, Katsumata N, Uchitomi Y (2014) “Effect of communication skills training program for oncologists based on patient preferences for communication when receiving bad news: a randomized controlled trial,” J Clin Oncol
Hoffman M, Steinberg M (2002) “Development and implementation of a curriculum in communication skills and psycho-oncology for medical oncology fellows,” J Cancer Educ
Bragard I et al. (2006) “Teaching communication and stress management skills to junior physicians dealing with cancer patients: a Belgian interuniversity curriculum,” Support Care Cancer
Dittrich C et al. (2016) “ESMO/ASCO recommendations for a Global Curriculum (GC) in medical oncology-edition 2016,” Ann Oncol
Beltrán D, Vergara C, Monsalve X, Madrid T, Sepúlveda P (2017) Implementación de un curso de entrenamiento en habilidades comunicacionales para residentes de medicina interna. Investig en Educ Médica 6(22):e17
Bascuñán ML (2011) Taller de manejo de situaciones difíciles, comunicación de malas noticias y auto-cuidado del profesional. Evaluación según la percepción de los participantes. Rev Educ en Ciencias la Salud 8(1):31–37
Baile WF (2000) “SPIKES--A six-step protocol for delivering bad news: application to the patient with Cancer,” Oncologist
Vandekieft GK (2001) “Breaking bad news,” Am Fam Physician
Lansdown M, Martin L, Fallowfield L (2008) “Patient-physician interactions during early breast-cancer treatment: results from an international online survey,” Curr Med Res Opin
Ying W, Chou S et al. (2017) “Discussing prognosis and treatment goals with patients with advanced cancer: a qualitative analysis of oncologists’ language,” Health Expect
Cox A, Jenkins V, Catt S, Langridge C, Fallowfield L (2006) “Information needs and experiences: an audit of UK cancer patients,” Eur J Oncol Nurs
Buiting HM, Rurup ML, Wijsbek H, Van Zuylen L, Den Hartogh G (2011) “Understanding provision of chemotherapy to patients with end stage cancer: qualitative interview study,” BMJ
García-Reyes W, Lara-Solares A, Guevara-López U, Flores-Rebollar A, Del Castillo AL (2008) “Cómo se dan las malas noticias de enfermedad terminal por un grupo médico no especializado en cuidados paliativos,” Rev Mex Anestesiol
Cherny NI (2011) Factors influencing the attitudes and behaviors of oncologists regarding the truthful disclosure of information to patients with advanced and incurable cancer. Psychooncology. 20(12):1269–1284
Jefferson L, Bloor K, Birks Y, Hewitt C, Bland M (2013) Effect of physicians’ gender on communication and consultation length: a systematic review and meta-analysis. J Health Serv Res Policy 18(4):242–248
De Vries AMM, de Roten Y, Meystre C, Passchier J, Despland J-N, Stiefel F (2014) Clinician characteristics, communication, and patient outcome in oncology: a systematic review. Psychooncology. 23(4):375–381
Epstein RM, Street Jr RL (2007) “Patient-centered communication in Cancer care: promoting healing and reducing suffering,” Communication
Aranda C, Cedillo R, del Campo M, Ornelas R, Góngora J (2014) “Factores Y Malas Noticias,” Acta Univ, vol. 24, no. 5, pp. 20–26
Ascencio-Huertas L, Allende-Pérez S, Castañeda-de La Lanza C, Verástegui-Avilés E (2013) La comunicación de las ‘malas noticias’ en cuidados paliativos. Gac Mex Oncol 12(4):276–279
Locatelli C, Piselli P, Cicerchia M, Repetto L (2013) Physicians’ age and sex influence breaking bad news to elderly cancer patients. Beliefs and practices of 50 Italian oncologists: the G.I.O.Ger study. Psychooncology. 22(5):1112–1119
Merckaert I, Libert Y, Razavi D (2010) “Communication skills training and research: the Brussels experience.”
Berkhof M, van Rijssen HJ, Schellart AJM, Anema JR, and van der Beek AJ (2011) “Effective training strategies for teaching communication skills to physicians: An overview of systematic reviews,” Patient Educ Couns
Levinson W, Roter D (1993) “The effects of two continuing medical education programs on communication skills of practicing primary care physicians,” J Gen Intern Med
Fallowfield L, Lipkin M, Hall A (1998) “Teaching senior oncologists communication skills: results from phase I of a comprehensive longitudinal program in the United Kingdom,” J Clin Oncol
Conflict of Interest
The authors declare that they have no conflicts of interest to disclose.
This study was performed through the application of an anonymous electronic survey, and the invitation for physicians to answer the questionnaire was made specifying and emphasizing that their participation was voluntary and their answers were completely anonymous, with no possibility for researchers to track either who answered the survey or which were each participant’s answers. Due to the anonymous and untraceable nature of the questionnaire and no more than minimal risk to participants related to the study, an ethics committee approval was not required.
Informed consent was obtained from all individual participants included in the study.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Platas, A., Cruz-Ramos, M., Mesa-Chavez, F. et al. Communication Challenges Among Oncologists in Mexico. J Canc Educ (2020). https://doi.org/10.1007/s13187-020-01703-7
- Bad news disclosure