Breaking the bad news of cancer: Exploring patient-doctor communication among clinical oncologists in Nigeria.

Abstract

e23251 Background: Nigeria ranks top on the incidence of cancer as well as on cancer-related deaths in Africa with an estimated 72,000 cancer-related deaths and 124,000 incidences annually. Cancer patients in this population, report some of the worst patient outcomes. Previous studies have explored several systems and patient-level factors responsible for the high cancer mortality, and poor outcomes. The process of breaking the ‘bad’ news of cancer to patients by the clinical oncologists in Nigeria has remained an understudied area. This study aims to explore the process of breaking the ‘bad’ news of cancer to patients by clinical oncologists (COs) in Nigeria. Methods: Participants ( N = 24) were clinical oncologists who treat and care for cancer patients in Nigeria. We used a semi-structured interview for the data collection. All the data were managed using Dedoose and used grounded theory for the data analysis. Results: Five themes were identified: (1) the process of breaking the ‘bad’ news is overwhelming, (2) COs need training on patient-doctor communication, (3) every process of breaking the bad news should be unique (4) patients should be the primary focus and (5) clinical workload is affecting the capacity of CO in breaking the ‘bad’ news. Conclusions: The findings show that there is a need for a more robust patient engagement and navigation program focused on empowering patients to ask the right questions. There is a need for the government to explore ways of reducing clinical workload among COs.