Breaking bad news to patients with spinal cord injury in Turkey - physiatrists' perspective

Objective: To explore Turkish physiatrists' experiences and opinions about breaking bad news (BBN) to patients with spinal cord injury (SCI). Design: A cross sectional study. Setting: Turkey. Participants: Sixty-nine physiatrists completed a questionnaire about experiences and opinions regarding BBN and self-assessment of communication skills (CS). Results: Eleven percent of specialists and 53\% of residents were trained on basic CS. All participants believed that physiatrists should play a role in BBN and the majority reported that they delivered the bad news in their clinic. Sixty-seven percent believed that the primary responsibility belongs to physiatrists. Sixty-eight percent reported that the most appropriate time for BBN is during rehabilitation. Self-assessments of CS were considered satisfactory in most steps of SPIKES protocol. Twenty percent told absolute truth to patients while 80\% stated that they did so sometimes or partially. Only 41\% confirmed that they do not use unrealistic statements to comfort patients. Fewer than 60\% stated that they performed the most appropriate and excellent behaviors for items in ``empathy{''} section. Conclusion: Physiatrists had different opinions about the style of BBN. Self-assessments of CS were optimistic, however physiatrists were not fully satisfied with their empathy skills