The Role of Health Care Professionals in Breaking Bad News about Death: the Perspectives of Doctors, Nurses and Social Workers

Background: The way a death is notified to family members has a long-term effect on their coping with their loss. The words caregivers use and the sentiments they express can stay with their hearers for the rest of theirlife. Aims: To study the views of three caregivers groups—doctors, nurses and social workers—as to their role in breaking a death news in an ED.Methods: One hundred and fifteen health care professionals participated in the research (51 nurses, 38 doctors and 26 social workers). They completed a 72-item questionnaire comprising behaviour descriptions, attitudes and statements. Content validation of the questionnaire was conducted by the help of experts group, and the internal reliability, measures in all its parts was 0.78 on average (α = 0.78).Results: Doctors gave a higher score than the other groups to their responsibility for breaking bad news (p<0.005) and to the content of the information they provide. Social workers scored the mental support given the family significantly higher than doctors and nurses did (p<0.000). Nurses scored the instrumental support given(tissues, water to drink) significantly higher than doctors and social workers (p<0.000). Breaking bad news caused social workers more mental distress than it did either doctors or nurses. All three groups gave a high score to the emotional exhaustion, sadness and identification this task caused them. Nurses felt more fear at theprospect of a notifying a death and made more effort to escape the task.Conclusions: The findings of the study will help develop performance guidelines for notifying a death and provide input for simulation and other training workshops.