Breaking bad news and empathic communication in cancer care

Abstract

In clinical oncology settings, both patients and physicians suffer from intense emotional anguish when discussing bad news. Patients' preferred communication consists of four components: setting up a supportive environment for interview, considering how to deliver bad news, discussing additional information, and providing reassurance and addressing patients’ emotions with empathic responses. The four components are associated with patients' psychosocial characteristics and cultural backgrounds. Based on the patients' preferences, a new communication skills training (CST) program for physicians have been developed in Japan. It is shown that communication skills that comply with patient preferences can be taught to physicians and their utilization decreases patient distress and improves physician performance and confidence in communicating with patients, using a randomized design. It is expected that all physicians will be provided an opportunity to learn communication skills and these efforts will further communication between patients with cancer and their physicians.