Breaking bad news in stroke rehabilitation: a consultation with a community stroke team

A much better use of their time would have been spent working on research that provides better outcomes rather than creating the nocebo effect.
http://informahealthcare.com/doi/abs/10.3109/09638288.2012.703757

Purpose: Within stroke care clinicians are frequently required to break bad news to patients, however, formal training and guidance remains limited. This article provides a case example of a multidisciplinary stroke rehabilitation team consultation, and aims to contribute towards an evidence base and a model of training for breaking bad news (BBN) in stroke care. Method: The stroke rehabilitation team requested clinical psychology consultation to help with difficulties they were experiencing in BBN to patients. The consultation comprised an assessment of the request, development of a proposal, delivery of a workshop on BBN and an evaluation of consultation impact. A collaborative consultation model underpinned the work, which aimed to empower and facilitate the team to generate solutions by drawing upon their existing expertise. Results: The consultation was found to meet the team’s expectations and needs. Consultees reported increased confidence to communicate difficult messages to patients and rated the consultation highly. A follow-up review indicated the consultation had led to changes in practice. Conclusions: Communication skills are central to BBN effectively. Clinicians may be supported to recognize their existing skill set and increase confidence in their ability to break bad news through a process of collaborative team consultation.

Implications for Rehabilitation

• Despite a lack of formal guidance stroke care clinicians are frequently required to break bad news to patients.
• Clinicians may be supported to increase confidence in their skills to break bad news through a process of collaborative team consultation.
• Developing an evidence base and training in breaking bad news should be considered a priority in stroke care.

So rather than coming up with good news, lets become better at delivering bad news. Complete failure.


Read More: http://informahealthcare.com/doi/abs/10.3109/09638288.2012.703757