Receiving Bad News by Telephone: The Lived Experience of Patients Undergoing the Diagnostic Workup for a Suspected Lung Cancer Diagnosis.

Abstract

Background: Telecommunication (telephone, video) is increasingly being used in healthcare, including in the cancer area. Still, patients' lived experiences of receiving bad news over the telephone of first a suspected and later a confirmed cancer diagnosis remain sparsely researched.

Objective: This study aimed to explore the lived experience of receiving results and plans by telephone in patients during an invasive workup for suspected lung cancer.

Methods: Individual interviews were conducted with 11 patients 2 to 3 months after the final disclosure of cancer. Data were analyzed and interpreted within a phenomenological-hermeneutic framework.

Results: When "being on a journey from anticipation to the fact of the cancer diagnosis," patients appreciated being gently guided via ongoing information by telephone. However, some calls were confusing or inconvenient or did not involve desired relatives. When "transferring toward the next step of treatment and care," patients felt warned and prepared for the planned disclosure of a cancer diagnosis by telephone.

Conclusions: Using telephone communication during the diagnostic workup is well-suited to support patients during the vulnerable time of receiving a cancer diagnosis. To be effective, informing patients by telephone must involve a relational structure of anticipation, including a warning and personalized approach to help them and their relatives gradually realize the bad news.

Implication for practice: This study contributes to the evidence base for breaking bad news via telecommunication. When connecting with patients remotely, an optimal procedure must be arranged so that matters of confidentiality, emotional concerns, and needs for involvement of relatives are explicitly ensured.