Guidelines for development a bad news process (diagnosis of cancer) at Cancer Clinic Udonthani Hospital

Abstract

Introduction: Cancer is the leading cause of death in the world and in Thailand. Patients who have been diagnosed with cancer will be aware of the high levels of stress that are the source of this qualitative research. There are two objectives. (1) Study context associated with the bad news (the diagnosis of cancer). (2) The study led to the preparation of guidelines. To reduce the stress of new cancer patients.

Method: Data were collected by reviewing documents / observations / in-depth interview/group discussion/ Field notes. Select a specific data provider. Key informants were 15 patients, 15 relatives, 2 physicians,/ 5 nurses / 5 nurese aids (as physician assistants). Data were collected between May 1, - July 30, 2017. Then analyzed using by content analysis.

Result: Context related to the bad news process (The diagnosis of cancer), (1) Service system and the place to report bad news. (2) Skills in using the process to tell the bad news of the officers (3) Availability of patients and relatives to hear bad news (The diagnosis of cancer) Patient and relative comments on how to report bad news are as follows. (1) Clarified that biospy shall be done for determine malignancy, this help them prepare thire mind. (2) It should be flankly speaking that it is cancer. (3) Avoid to use unclear words to make confusion. (4) Doctor did not give enough information about disease. (5) Do not give the time to make decision the treatment. Patients and relatives need three issues from health professionals, (1) On, they want to see a doctor as soon as possible because of anxiety and stress. (2) Need more information about the disease/ stage of disease / treatment / survival. (3) Need a good relationship from the health team.

Conclusion: The process of reporting bad news (the diagnosis of cancer) in Udonthani Hospital was no specific formats or Six-step-protocol. Because the place is not suitable and there are many patients waiting, them patients was stressed because they received less information than they need after first time cancer diagnosis. So can not take long time to explained.