Giving bad news: The family perspective

During the study period, researchers at Harborview Medical Center in Seattle, WA contacted family members of trauma patients who had died either in the Emergency Department or the Trauma Intensive Care Unit. The researchers, using a graded survey by telephone or by mail, attempted to ascertain the importance of certain described elements to the family members as they were receiving the news of the traumatic demise. From this information, the components were ranked in terms of importance. The most significant features of delivering bad news were described as the attitude of the news-giver, clarity of the message, privacy and the knowledge and ability of the news-giver to answer questions. The elements of least importance to the family included attire of the news-giver, and their “rank” or seniority. The overall results of this survey determined that the manner in which families were told of the death of a loved one from a traumatic mechanism is extremely important and it may impact upon the survivors for the rest of their lives. Certain behaviors of the news-givers that were perceived by the families as most helpful included a caring attitude, being well-informed and providing clarity of communication. Providing privacy and time to the families so that they may absorb the information with dignity appears to be among the top-ranked elements. The authors recommend that an educational module be included in the medical schools’ curricula to address these issues with new physicians. Trauma is a disease of opportunity and the team member responsible to deliver the bad news may need to utilize the information gleaned from this study, and should have it available to them.