Patients' perceptions of receiving bad news about cancer

Purpose: The purpose of this investigation was to document patients' recoll ections about what transpired during bad news interactions between physicia ns and themselves. Patients and Methods: One hundred twenty cancer patients provided information about the most recent time they received bad cancer-specific news. Using a series of descriptive statements, patients reported an what the physician did while c ommunicating the bad news. Patients also indicated the extent to which they were satisfied with the transaction and whether they believed that the int eraction had any long-lasting impact on their adjustment or on their subseq uent interactions with the physician who delivered the news. Results: Overall, patients reported having similar experiences, with most p hysicians behaving in ways that were consistent with advice published in th e medical literature. Satisfaction with the bad news transaction was high. Younger patients and women found the transaction to be more stressful, and older patients believed that the transaction was less important for subsequ ent interactions with the physician. Logistic regression analyses indicated that satisfaction with the transaction was uniquely predicted by factors r elated to the environment, to what the physician said, and to how the physi cian said it. Conclusion: Despite high levels of self-reported satisfaction by patients, some factors differentiated the most satisfied patients from patients who w ere less satisfied. The findings suggest that special attention should be g iven to making the environment comfortable, taking plenty of time with the patient, and attempting to empathize with the patient's experiences. (C) 20 01 by American Society of Clinical Oncology.