A qualitative study of stress and coping responses in doctors breaking bad news

Abstract

Objective: Breaking bad news (BBN) is a significant source of stress for doctors. In this study we qualitatively explored doctors' perceptions of their BBN experiences, to identify the range of appraisal and coping processes associated with this task. Methods: Individual semi-structured interviews were conducted with 28 junior and senior doctors. Results: Doctors recalled physical and emotional stress symptoms during the BBN task, although they tended not to describe it as a 'stressful' experience. Senior doctors appeared to engage in more problem-focused and meaning-focused coping strategies than junior doctors, and this may have been due to their greater experience and control over patient selection and work structures. Conclusions: This study provides insight into the range of different coping responses experienced by doctors in relation to the task of breaking bad medical news. Practice implications: The results reinforce and refine the imperative for further training to address the impact of BBN from the doctor's perspective if performance of this critical task is to be improved.