The difficulty of breaking bad news: Experiences and perspectives of paediatric of healthcare workers at Queen Elizabeth Central Hospital in Malawi
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Date
2022-02-08
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Kamuzu University of Health Sciences
Abstract
Type of Study: Mixed methods case study
Problem: Paediatric healthcare workers at QECH may or may not initiate palliative care discussions
with patients and family members at the time of diagnosis, which can lead to the development of
multiple communication challenges. The biggest challenge involves paediatric healthcare workers not
effectively breaking bad news to patients and their families. Some are not taking the time to break
bad news and to be the needed presence that enables patients and families to overcome the physical,
mental, and emotional barriers caused by advancing illness. Due to the emotionally and
psychologically complex nature of breaking bad news, paediatric healthcare workers need to be
consistently engaged in the process of breaking bad news to promote individuals’ digestion and
retention of important information (diagnosis, prognosis, etc.) and to provide the necessary support to
paediatric patients and families throughout the continuum of care. To achieve this, there is a need to
understand the experiences and perspectives of paediatric healthcare workers and to identify the
barriers they face in breaking bad news to patients and their families.
Objectives: Our main goal is to understand the challenges paediatric healthcare workers experience in
breaking bad news to paediatric patients and their families at QECH. We aim to describe how
comfortable and confident paediatric healthcare workers believe they are when breaking bad news to
patients and their families. We also hope to understand paediatric healthcare workers’ perceptions of
their role in breaking bad news. We then intend to unearth factors influencing the inconsistent
breaking of bad news by paediatric healthcare workers to patients and their families. From our data,
we will make recommendations for improving the process of breaking bad news to paediatric patients
and their families.
Methodology: We plan to conduct an initial survey to obtain a general overview of paediatric
healthcare workers’ experience in breaking bad news and to identify the scope of palliative care
training received by paediatric healthcare workers at QECH. The survey will be sent to all paediatric healthcare workers within QECH, which includes approximately fifty individuals. Following the
initial survey, open-ended, semi-structured, in-depth interviews will be conducted with fifteen of the
respondents.
Expected Findings and Dissemination: Findings of this study will help inform palliative care
practice at QECH and similar settings locally and internationally. All results will be presented in
report form. A copy of the final report will be submitted to all research partners and the College of
Medicine Research Ethics Committee (COMREC). Additionally, a report will be submitted to the
Glynn Family Honors Program at the University of Notre Dame in Notre Dame, IN USA.
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Keywords
Breaking bad news