Bad news and emotional support

Abstract

Health professionals frequently find ourselves in a situation where we have to communicate bad news. A lack of formation in areas of communication, in general, means that giving bad news gives rise to anxiety and insecurity within us, and can even mean that more pain than necessary is produced when informing. By means of this review we wish, initially, to create a space for reflection on what constitutes bad news and whether or not we should communicate this in situations where the vital prognosis is bad. From a practice centred on the patient, we believe that the category of bad news is something that must be assigned by the person who suffers from it, and the one who suffers from it has the right to be informed if he so wishes. Having made this reflection, we go on to describe certain skills needed in the communication of bad news and a strategy of progressive information by stages (Buckman's strategy) that we believe to be appropriate to our cultural and work milieu. Finally, we draw attention to the need for a subsequent follow-up to the information from the fields of education and the health promotion when informing about, and dealing with, chronic diseases, and from the field of emotional accompaniment when dealing with diseases whose vital prognosis is bad. We emphasise the need for allowing and facilitating the expression of fears in situations of therapeutic uncertainty in order to carry out a real accompaniment and to alleviate, to the extent that we can, the approach to death, in case this should finally be reached.