• Pak J Med Sci · Nov 2018

    Breaking Bad News: A contextual model for Pakistan.

    • Lubna Baig, Sana Tanzil, Syeda Kauser Ali, Shiraz Shaikh, Seemin Jamali, and Mirwais Khan.
    • Prof. Dr. Lubna Baig, MBBS, MPH, MMEd FCPS, PhD, APPNA Institute of Public Health, Jinnah Sind Medical University, Karachi, Pakistan.
    • Pak J Med Sci. 2018 Nov 1; 34 (6): 1336-1340.

    ObjectivesThe purpose of the study was to identify the sequence of violence that ensues after breaking bad news and develop a contextual model of breaking bad news and develop a model contextual for Pakistan.MethodsA qualitative exploratory study was conducted using Six FGDs and 14 IDIs with healthcare providers working in the emergency and the obstetrics and gynecology departments of tertiary care hospitals of Karachi, Pakistan. Data was transcribed and analyzed to identify emerging themes and subthemes using thematic content analysis.ResultsImpatience or lack of tolerance, lack of respect towards healthcare providers, unrealistic expectations from healthcare facility or healthcare staff were identified as main reasons that provoked violence after breaking bad news. A conceptual five step model was developed to guide communication of bad news by the health care providers. On initial testing the model was found to be effective in de-escalation of violence.ConclusionCommunication of bad news requires application of specific approaches to deal with contextual challenges for reducing violence against healthcare.

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