Breaking bad news to cancer patients: Insights from Ethiopian oncology professionals

Abstract

Breaking bad news (BBN) is a challenging yet essential responsibility for healthcare professionals, particularly in oncology care, requiring empathy, effective communication, and professional competence. Limited evidence exists on how healthcare professionals perceive and practice BBN in low-resource settings such as Ethiopia. This study explored oncology healthcare professionals’ perceptions and practices regarding BBN with cancer patients at Tikur Anbessa Specialized Hospital in Ethiopia. A qualitative phenomenological study was conducted using in-depth interviews with oncology health care professionals, including BSc nurses, MSc oncology nurses, residents, and consultants. Participants were purposively selected to capture diverse experiences in BBN. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed using qualitative content analysis. Two main themes emerged. The first theme, perceptions of BBN, included subthemes of perceived benefits of disclosure, disclosure thresholds, and optimal communication approaches, emphasizing the importance of informing patients to support informed decision-making and treatment planning. The second theme, self-reported practices, comprised subthemes of personal practices and emotional responses. Participants highlighted the absence of standardized institutional guidelines and protocols, leading them to rely on personal experience and professional judgment. Although they attempted to maintain emotional composure, many experienced distress before and after disclosure. Participants stressed the need for trained personnel, adequate time, and supportive environments to facilitate effective communication. Although participants recognize the importance of BBN, the absence of standardized institutional frameworks, structured training, and supportive environments presents significant challenges. Developing culturally tailored protocols and strengthening communication training may improve patient-centered cancer care in Ethiopia.