Medical students' attitudes towards breaking bad news: An empirical test of the World Health Organization model

The literature regarding breaking bad news distinguishes three disclosure m odels: non-disclosure, full-disclosure and individualized disclosure. In this study, we investigated the relations between attitudes regarding di sclosure of bad news and global professional attitudes regarding medical ca re in a sample of medical students (n = 88). The Attitudes towards Breaking Bad News Questionnaire was developed and factor analysed to provide a vali d and reliable instrument to measure attitudes regarding disclosure of bad news. The results indicate a preference for an individualized, patient-cent red disclosure model in male and female students. Regarding the global prof essional attitudes, female students appear more humane-oriented than male s tudents. Second, the relationship between global professional attitudes and attitude s regarding breaking bad news was examined by means of correlational and cl uster analysis. The inter-relationship between global professional attitude s and attitudes regarding bad news is poor. Results of the cluster analysis , however, suggest that the sample can be divided into subsamples represent ing different disclosure clusters on the basis of specific combinations of global professional attitudes regarding medical care and attitudes regardin g breaking bad news. The results are discussed in view of the theoretical f ramework proposed by the World Health Organization (WHO) in their training module on communication of bad news. Copyright (C) 2001 John Wiley & Sons, Ltd.