Communicating bad news: an integrative review of the nursing literature

integrative review of the literature for articles in Portuguese and English published between 1993-2014, in the databases: Bireme, PubMed, Scopus, Web of Science, CINAHL and Embase. Nine articles were included using the selection flow chart. A digital form was completed for each article according to the Consolidated Criteria for Reporting Qualitative Research checklist and the level of scientific evidence was determined.

Results:

Of the 99 articles in identified, nine were included after applying the selection flowchart.

Discussion:

breaking bad news is frequent in the area of oncology and palliative care, with a strong cultural influence on the autonomy of nurses in this process.

Conclusion:

the approach and skills of the nurse during this task influences the patient’s reaction to the message. The theme is scarce in the literature and merits further investigation.

Descriptors:
Truth-Telling; Communication; Nursing; Family; Information

Title	Year/country	Design	Interventions	Conclusions	COREQ^* * Consolidated Criteria for Reporting Qualitative Research; maximum number of items = 32; /evidence level^ level of evidence I to VII.
Decision-making in palliative care practice and the need for moral deliberation: a qualitative study.	2004 Holland	Qualitative approach	Interviews	It is important to preserve the autonomy and decision making of the patients by offering correct information.	24/VI
Percepções da família do recém-nascido hospitalizado sobre a comunicação de más notícias.	2009 Brazil	Qualitative approach	Interviews	The contents of the message should be clear and detailed regarding health condition and treatment of the child, without ambiguity and wholly true, while offering support to face the news.	22/VI
Review of communication and family caregiver content in nursing texts.	1999 USA	Literature review	Database search	There is a great opportunity to improve the teaching of nursing regarding the "end-of-life". The publications on the theme require improvement.	Not applicable/V
A phenomenological study of nurses' understanding of honesty in palliative care.	2010 Sweden	Qualitative approach	Interviews	For palliative care it is necessary for the nurse to have ethical virtues and communicate with honesty.	26/VI
Patterns and barriers in information disclosure between health care professionals and relatives with cancer patients in Greek society.	2005 Greece	Literature review	Database search	Teaching institutions should stimulate studies into palliative care and the training of future care professionals regarding the theme.	Not applicable/V
Should palliative care patients' hope be truthful, helpful or valuable? An interpretative synthesis of literature describing healthcare professionals perspectives on hope of palliative care patients.	2013 Holland	Literature review	Database search	Health care professionals should focus on balancing hope and truth.	Not applicable/V
Cancer patient expectations of and communication with oncologists and oncology nurses: the experience of an integrated oncology and palliative care service.	2000 Israel	Qualitative approach	Interviews	There is a necessity for powerful and quality interpersonal communication skills among those providing care for cancer patients.	19/VI
To tell or not to tell: attitudes of Chinese oncology nurses towards truth telling of cancer diagnosis.	2007 China	Qualitative approach	Questionnaire	Nurses believe that the doctor is a health professional most suited to communicate the truth.	25/VI
Lebanese cancer patients: Communication and truth-telling preferences.	2008 Lebanon	Qualitative approach	Interviews	There is a need for truthful communication with the patients and their family members	27/VI

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[1] CORRESPONDING AUTHOR: Daniele Vieira de Menezes. E-mail: dvieiramenezes@gmail.com