Background: Breaking bad news (BBN) is a routine but distressing task for physicians and patients. Patients suffer considerable discomfort when bad news such as disease recurrence or spread, or treatment failure is disclosed to them. Their physicians; therefore, should acquire effective communication skills to help them overcome these feelings.
Objectives: To assess the physicians' awareness and practice of breaking bad news to patients.
Method: a cross-sectional study was carried out in a rural family health center (FHC), Menoufia, Egypt. A semi-structured questionnaire based on the six-step SPIKES protocol for BBN was administered to 170 physicians working and training in the FHC to assess their awareness of the process. Their practice was assessed against a checklist.
Results: About 68% of the physicians had a good perception of the components of the 6-step SPIKES protocol while 58% implemented the protocol at a fair level. There was a statistically significant difference among physicians' results based on specialties, as family physicians and general practitioners had higher awareness and practice scores. as regards their qualifications, physicians who hold Ph.D. degrees or fellowships had statistically significant better awareness and practice scores. The physicians who received training on breaking bad news have higher perceptions and practice scores. There was a statistically significant positive correlation between participants' years of experience and their awareness and practice.
Conclusion: Physicians' awareness of BBN is good; however, their technique of practicing it is fair. It is a neglected issue in physicians' education and training with particularly in the case of novice physicians.