John Libbey Eurotext



The difficulties to announce the diagnosis of severe illness for the French hematologists Volume 15, issue 2, mars-avril 2009

Service d’hématologie et thérapie cellulaire, CHU Bretonneau, Tours, Département de psycho-oncologie, Institut Gustave-Roussy, Villejuif, Pôle de la cancérologie, Université Joseph-Fourier, Grenoble

The objectives of this study were to evaluate the causes of the difficulties for hematologists to announce bad news to patients. A questionnary composed of three parts was sent by e-mail to the 917 members of the French Society of Haematology. The first part included social and demographic informations. The second part included 14 items evaluating the level of stress to announce bad news and the reasons of this stress: fear to provocate some reactions in the patients or in himself. The third part was an autoevaluation of their competences and the quality of their formation in communication by the praticians.ResultsOne hundred seventeen hematologists completed the questionnary. 58.1% affirm not to be in difficulty when announcing bad news. If difficulties, there were more linked to the fear to be himself in difficulties than to induce difficulties in the patient: fear not to be able to respond to the emotion of the patient (p < 0.001), suffering when talking about the death with the patient (p = 0.002), fear to deprive the patient of any hope (p = 0.0039), fear not to be able to respond to the questions of the patient (p = 0.0048), suffering with the patient (p = 0.0094), fear to induce suffering in the patient (P = 0.0139). These difficulties appeared linked to the competences (p < 0.05) and to the formation in communication of the practicians (p < 0.01), the competences being linked to level of the formation (p < 0.001).ConclusionIt appeared that it is difficult to announce bad news for almost half of the French Hematologists who responded. The link between competences and formation leads to introduce the formation in communication in the initial theorical and practical training of the medical students and the future hematologists.