1. STUDY OF EFFECTIVENESS OF BREAKING BAD NEWS FOR PALLIATIVE CARE CANCER PATIENTS IN MONGOLIA
Т. Аltankhuyag1, D. Odontuya2
1 Doctor of Grace hospice, Master student of MNUMS
2 Teacher of GP Dept. SOM, MNUMS, MD., Ph.D., professor
Introduction
Cancer is 2nd cause of death in Mongolia patients died because of cancer and 2353 (64.3%) patients died within first year after diagnosis. It is always difficult to tell true about diagnosis, prognosis to patients with incurable cancer. There is not exists the study on effectiveness of breaking bad news in Mongolia and we don’t know how Mongolian patients react to the 6 steps of breaking bad news, established in foreign countries.
Results:
All patients in 100% want to know about their diseases and results of investigations. All patients had short reaction to bad news: 16% of patients had tearing, 30% - took silent and sighed, 32%- were angry because of late diagnosis and angry to family because of hiding the true, 22%- still did not believe to bad news and express the wish to be cured.
We provided study of the results of breaking bad news after one week by observation and questionnaire. We found out, 18% of patients wished to complete some activities, 4% of patients already prepared testament, 28% of patients stopped looking for curative treatment and stopped to spend money for unnecessary treatment, 38% of patients had psychological rehabilitation, because they had palliation of depression, anxiety, insomnia and anger, 56% of patients answered to questionnaire, that they accepted real situation with diseases and prognosis. 100% of patients answered to question, that breaking bad news was very important for them.
Goal
Study of effectiveness of breaking bad news for palliative care cancer patients in Mongolia
Fig 1. Direct reaction of patients to bad news Fig 2. Reaction of patients to bad news after one week
Methodology:
We provided breaking bad news by Robert Buckman-6 steps for 50 cancer patients, who received palliative care in Grace, Hope and Green Home hospices. We provided clinical observation of patients’ reaction directly and after one week after breaking bad news. We used questionnaire with 30 questions about effectiveness of bad news.
We analyzed the results of study using SPSS 19.
Conclusion:
1. 100% of patients want to know true about diseases, results of investigations and prognosis.
2. 100% of patients decided, that breaking bad news was very important for them, because they accepted the diseases and prognosis, stopped looking for unsuccessful treatment, achieved psychological rehabilitation, and started to spend last months of life with sense and quality.