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NEWS
IIT FITRIANINGRUM
DEPARTEMEN BIOETIKA DAN
HUMANIORA
PRODI PENDIDIKAN DOKTER FK UNTAN
BACKGROUND
Anxiety from the patient increase when patient were given the bad
news (Lienard et al, 2006)
Other studies showed that when reported about bad news, 54% will
shock, 46% will frigth, 24% akan sedih, 40% akan menerima dan
hanya 15% that wont worry (Whippen and Cannelos, 1991)
Worry that will be difficult to handle the reaction of patient & their family
Barnett (2002) found that when patient given the doctor about bad
news, 49% will neutral, 20% will have positive perception, 20% will
negative perception, 6% will have a very negative perception on
doctor
People will most likely not remember about the information (Eden,
1994)
Breaking Bad News/EBP3KH
TA.2014/2015
Setting up the
interview
Perception of the
Patient
Invitation by the
patient
Knowledge to the
patient
....Knowledge to the
patient
Emotions of the
patient
...Emotions of the
patient
...Emotions of the
patient
...Emotions of the
patient
...Emotions of the
patient
Validating responses
I can understand how you felt that way
I guess anyone might have the same reaction
You are perfectly correct to think that way
Your understanding of the reason for the tests is
very good
Many other patients have had similar experience
It will reduce patients isolation and validate the
patients feelings/thoughts as normal and to be
expected
Strategy and
Summary
Patients who have a clear plan for the future are less
likely to feel anxious and uncertain
Ask if patients are ready to discuss this
Clinicians are often uncomfortable doing this
especially in unfavorable prognosis
Explore patients ICE (ideas, concerns and
expectations)
Understand specific goals patient may have like
symptom control and pain relief
Give hope in terms of what is possible to
accomplish
Breaking Bad News/EBP3KH
TA.2014/2015
Falsehood is so easy,
truth is so difficult
(George Elliot)
Ilustrasi
Dua pasien dibawa ke UGD dengan mobil polisi. Mereka berdua adaah
suami istri yang mengalami kecelakaan lalu lintas. Karena trauma yang
parah, sang suami setelah diupayakan tindakan penyelamatan jiwa
tidak dapat terselamatkan
Sang istri dalam keadaan sadar dan tengah dirawat di ruangan yang
lain yang berbeda. Karena terjadi perdarahan dan trauma pada
beberapa organ vital di dallam rongga thorax dan abdomen, dokter
Sp.B memutuskan untuk segera melakukan operasi
Ketika saudara mempersiapkan pasien tersebut untuk dioperasi, pasien
tersebut bertanya kepada saudara mengenai keadaan suaminya,
Bagaimana keadaan suami saya dok? Apakah dia juga harus
dioperasi? Saya ingin bertem dengan dia sebelum saya dioperasi!
Jika saudara adalah dokter yang merawat pasien ini, apa yang akan
saudara katakan kepada pasien tersebut
Breaking Bad News/EBP3KH
TA.2014/2015