International Journal of Research and Innovation in Social Science (IJRISS) |Volume VI, Issue IX, September 2022|ISSN 2454-6186
David K. Chumba*, Boibanda Osotsi, Irene Marete and Prof. John Changach
Department Medical Education, Moi University, Kenya
*Corresponding Author
Background: Breaking bad news refers to a medical procedure of passing unfavourable medical information to patients about their illnesses. Competence in this skill is required in medical practice. Specific guidelines in delivering bad news have been developed to assist doctors break bad news. There is increasing burden of life-threatening diseases in Sub Saharan Africa that necessitated relooking at the training of breaking bad news skills among doctors.
Aims and objectives: The objective of this study was assessing the perspectives of residents in their competence in Breaking Bad News tasks and if there is any relationship between residents’ perceived competence and sociodemographic characteristics.
Methods: A mixed methods approach used to collect data. Qualitative data and focus group discussions and in-depth interviews; quantitative data; perceived competence, was measured using aspects of competence, self-efficacy Empathy and Physicians beliefs. Study population constituted postgraduate doctors who were 240 at that time 30% sampling ratio used to select a sample of 80, purposeful sampling used to identify 7 residents doctors for focus group discussions and 3 lecturers for in-depth interviewed. Data was collected using questionnaires and focus group discussion guide and in-depth interview guide, quantitative data was cleaned and entered and analyzed in SPSS version 22, descriptive statistics used to describe, and inferential statistics used in comparing data. Qualitative data was analysed and presented thematically. A p-value of <_ 0.5 was set as significant for all tests.
Results: Competence in breaking bad news varied on three aspects: self-efficacy 134% of the normed value, however focus discussion groups this is overrated, empathy 74% of normed value, physicians beliefs scores 160% of the normed value, (N=80) 45% and 55% of the participants were female and male respectively 46% were in part 1 54% in part 2. Gender did not significantly influence competence self-efficacy t(78)=0.152 p= 0,876, empathy t(78)=0.015 p= 0.897 physician belief score t(78) =0.121 p=0.736 while level of training significantly influenced with part 2 residents being better in all aspects of competence; self-efficacy t(73)=0.427, p= 0.004., empathy t(73) 0.331 p =0.023, physician belief Score t(73) =0.213 p= 0.018.
Conclusion: Resident doctors do not perceive themselves to be competent in breaking bad news tasks. Additional training and level of training significantly influences all aspects of competence in breaking bad news.