Subject Areas:
(a) Setting the Stage: This section looks at whether the doctor facilitated an initial rapport before breaking the bad news.
(b) Breaking the News: This section specifically focuses on whether the doctor was sensitive to the patient's perspective when he/she delivered the news.
(c) Eliciting Concerns: This section focuses on whether the doctor actively attempted to gain a clear idea of the personal implications and meaning of the news to the patient, and the concerns that it generated.
(d) Information Giving: This sections looks at aspects other than giving the news itself.
(e) General Considerations: These points relate to the interview as a whole.
A. Setting the Stage: 3 items
B. Breaking the News: 5 items
C. Eliciting Concerns: 3 items
D. Information Giving: 4 items
E. General Considerations: 8 items
Graded Responses:
• range from 1 to 5, with 1 "poor" and 5 "very well"
• wording "very well" to "poorly": 1, 23
• wording "definitely" to "not at all": 2, 3, 5, 6, 7, 8, 9, 10, 13, 14, 20, 22
• wording "carefully" to "not at all": 4, 11
• wording "entirely" to not at all: 12
• wording "always" to "frequently inaccurate: 15
• wording "all ten" to "none at all": 16
• wording "all of them" to "none at all": 17
• wording "fully" to "not at all": 18
• wording "always" to "not at all": 19
• wording "never clumsy" to "often clumsy": 21
Breaking bad news Assessment Score =
= SUM(points for all 23 items)
Interpretation:
• minimum score: 23
• maximum score: 115
• The higher the score, the better the handling of bad news delivery.
The behavior of the physician for each item can be described based on 2 to 6 features.
