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This article investigates the dissipation speed of positive and negative news in a geopolitical context. We perform a sentiment analysis of geopolitical news and measure the gamma of the corresponding sentiment scores per time unit in order to compare the travel speed of news with positive sentiment scores with news having negative sentiment scores. While prospect theory suggests that bad news is perceived as more impactful than good news, we show that this does not necessarily hold for the travel speed of news. On the contrary, we find that good news linked to keywords, which have usually a negative association, travel faster than bad news, and vice versa; a seeming repudiation of folk wisdom. Since our use cases were geopolitical crises, we associate phrases connected with conflict or the potential for conflict to have a broadly negative association. The implications of our insights suggest that the dissipation speed of news can be improved by framing and releasing positive news about events or entities with a negative association. [ABSTRACT FROM AUTHOR]

A first person narrative is presented that explores the author's experience of delivering bad news.

Is the reluctance to share bad news (i.e., the MUM effect) motivated more by a public display or private concern, and does it benefit mainly the messenger or the recipient? An experiment (N = 309) that crossed good/bad news with three communication channels (face-to-face, text messaging, e-mail) revealed that messenger reluctance was greatest under conditions of bad news and did not vary based on the channel through which the recipient contacted the messenger. In contrast with earlier work, this MUM effect was more consistent with a private fear of distressing the recipient. Theoretical implications and limitations are discussed. [ABSTRACT FROM AUTHOR]

Messengers are reluctant to reveal bad news, and this reluctance can hamper effective communication. With this investigation, we explore linkages among the topic of the news, messengers’ reasons for sharing, messenger concerns about sharing, the locus of the news, and whether these variables associate systematically with messenger reluctance to share the news. Retrospective self-reports (n = 330) revealed that bad news occurred in reliable topic categories, which in turn related to reasons for sharing, how extreme the news was perceived to be, and the concerns messengers had before sharing the bad news. Messengers reported more reluctance to share the news when they were also the locus of the news than when they were not, and they felt reluctance was greater when the topic was seen as more extreme. Theoretical implications and limitations are discussed. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explore the question of if and when leaders should communicate bad news to their stakeholders. Previous research in the crisis communication literature has highlighted the need to communicate quickly and persuasively to minimize losses; however, the authors argue that such tactics assume certainty in negative outcomes and tend to generate predominantly one-way, company-centric communication. In this paper, the authors propose that under conditions of uncertainty (i.e. when the bad news has an unknown outcome or cause) different communication strategies are needed. Design/methodology/approach – Drawing on the stakeholder theory, the authors argue that organizational decision makers have a clear moral obligation to share bad news with affected stakeholders. The authors then review the existing approach to crisis communication and discuss its limitations under conditions of uncertainty. Finally, the authors develop a set of scenarios to guide the communication of bad news under conditions of uncertainty. Findings – The authors formulate a framework to guide leaders on how to communicate with stakeholders when the nature of the bad news is uncertain and open to multiple interpretations. The authors propose a situational approach for responding to stakeholders that emerges from the context of the bad news. Originality/value – The authors propose a situational framework for communicating bad news that overcomes the current limitations of extant crisis communication strategies under conditions of uncertainty. This involves balancing existing crisis communication recommendations with a more collaborative sensemaking approach. [ABSTRACT FROM AUTHOR]

Research on bad news delivery reveals a reliable temporal delay in the onset of the bad news message from the sender to the receiver. Two experiments utilized a false feedback test design to determine whether the delay is better accounted for by negative verbal message planning, politeness, or both. Both studies (Ns = 135 and 138) featured participant-senders who delivered either scripted or unscripted good, neutral, or bad news to a stranger. News valence, delay before response, and reluctance were measured. Both experiments supported the functional politeness explanation. Study 2 also supported the negative verbal message–planning explanation. Implications and limitations are discussed. [ABSTRACT FROM PUBLISHER]

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Explanations for the hesitation to share bad news (i.e., the MUM effect) have emerged largely absent of an organizing theoretical framework. The current article aims to recast these explanations in terms of the face-related concerns senders anticipate when sharing bad news. Specifically, we questioned whether face-related concerns mediate the link between the valence of the news and the psychological reluctance and behavioral hesitation that are subsequently triggered in senders. Two samples (Ns = 138, 229) using different experimental methodologies revealed data consistent with mediation for two different concerns (fear of distressing the target, desire to avoid a negative mood). Implications for MUM effect research and limitations are discussed. [ABSTRACT FROM PUBLISHER]

Data breaches have become a seemingly unavoidable aspect of the information age for both consumers and organizations. Breaches have tangible consequences, including the increased possibility of identity theft for consumers who see their personally identifiable information (PII) compromised. Organizations also face particular issues from data breaches, including damage to organizational reputation. In the United States, organizations are required to notify consumers in the event of a data breach. These notifications feature some aspects that are mandated by the state. However, organizations could control many aspects through the use of perspectives such as speech act theory and impression management techniques. In this article two studies examined the performance of language in letters sent to notify consumers whose PII had been affected by a security breach. Study 1, using a theoretical framework consisting of speech act theory, conditions of felicity, and visual presentation, analyzed 212 letters for specific elements. Study 2 used a 2 × 2 between-subjects design in which participants received sample stimulus letters in order to measure the effectiveness of visual presentation techniques on consumers. The results suggest that use of impression management techniques can produce a positive outcome when organizations send notification letters. [ABSTRACT FROM PUBLISHER]

In two experiments we compared contrasting findings on bad news transmission likelihood between literature on rumors and the MUM-effect in order to contribute to the development of a more general theory of news transmission. We argued that several contextual differences account for the contrasting findings between these research conditions. We predicted that fate similarity and fate uncertainty (both present in many rumor contexts and absent in most MUM-contexts) enhance the anticipated personal outcomes of bad news transmission for communicators and hence increase bad news transmission. Supporting our argument, we found that fate uncertainty and fate similarity each increased the likelihood of bad news transmission up to the level of good news transmission. Furthermore, these effects were mediated by communicators’ anticipated personal outcomes of transmission. In addition, Experiment 2 demonstrated anticipated personal outcomes to be only an important motive for news transmission decisions in superficial relationships; for close relationships, experienced moral responsibility appeared to be the paramount motive for transmission. [ABSTRACT FROM PUBLISHER]

Background:Although patients with cancer are often accompanied by a relative during breaking bad news (BBN) consultations, little is known regarding the efficacy of training programmes designed to teach residents the communication skills needed to break bad news in a triadic consultation.Methods:Residents were randomly assigned to a 40-h dyadic and triadic communication skills training programme (n=48) or a waiting list (n=47). A simulated BBN triadic consultation was audiotaped at baseline, and after training for the training group, and 8 months after baseline for the waiting list group. Transcripts were analysed using content analysis software (LaComm). A coder determined the moment of bad news delivery and the relative's first turn of speech regarding the bad news. A generalised estimating equation was used to evaluate residents' communication skills, BBN timing, and the relative's inclusion in the consultation.Results:Ninety-five residents were included. After training, the duration of the pre-delivery phase was found to be longer for the trained residents (relative risk (RR)=3.04; P<0.001). The simulated relative's first turn of speech about the bad news came more often during the pre-delivery phase (RR=6.68; P=0.008), and was more often initiated by the trained residents (RR=19.17; P<0.001). Trained residents also used more assessment (RR=1.83; P<0.001) and supportive utterances (RR=1.58; P<0.001).Conclusion:This study demonstrates that a training programme that focuses on the practice of dyadic and triadic communication skills can improve the communication skills of the participating residents in a BBN triadic consultation. Such a training should be included in resident curriculum. [ABSTRACT FROM AUTHOR]

People are reluctant to share bad news. Reasons include self-presentation and sensitivity to receiver emotionality. An experiment investigated these reasons during interactions between friends and strangers. Females (N = 330, 165 dyads) gave good or bad news to a close friend or stranger. Time to response was recorded. The MUM effect replicated for both friends and strangers. No main effects for friend/stranger or interaction between friend/stranger and news valence were found. Data were more consistent with a self-presentation explanation. Behavioral data were also analyzed to explore communicative behavior that accompanies the sharing of good and bad news. Limitations and implications are discussed. [ABSTRACT FROM AUTHOR]

Background. In general, the principles of palliative care suggest that, at some stage, patients should be given 'bad news' about poor illness prognosis. The information is often important for care planning, especially when it involves disclosure to children. Although there are ongoing debates about whether to tell or not to tell children bad news, these debates have largely been informed by patients who live in a developed-world context. In contrast, this paper focuses on telling bad news to children and their families from a rural, developing-world context. Objective. To analyse the experiences of providers of palliative care to children when they attempted to fulfil one of their roles as palliative caregivers, i.e. to prepare patients and families for a child's poor illness prognosis. Method. This was an exploratory study that was approached qualitatively. Five nurses and eight home-based care workers who provided palliative care for children in rural areas of South Africa formed a purposive, information-rich, self-selected sample. Data were produced through discussions with participants, using photographs taken by the caregivers to stimulate and contextualise the discussions. Results. Participants experienced four dilemmas with regard to telling bad news: when families did not want to be told any bad news; when participants felt uncomfortable about telling bad news; when participants and patients shared dissimilar values about telling bad news; and when participants were unsure about when to tell bad news. Conclusion. In the rural areas where the study was conducted, children are not usually given bad news about their illness. Disclosing poor prognosis led to the dilemmas faced by caregivers. The result was that the emotionally charged work of caring for children reaching the end of their lives became more challenging for the caregivers because they were not prepared for cultural complexities. In view of the findings of this study, there is a need for ongoing research into paediatric palliative caregiving in context. [ABSTRACT FROM AUTHOR]

In argumentative texts, authors must choose between two presentation orders: providing the decision or claim first and then the explanation (direct order) or providing the explanation first and then the decision (indirect order). This study addresses which presentation order is most effective when the decision entails bad news by discussing two experiments that evaluate Dutch letters and e-mails. The first experiment evaluates denial letters from insurance companies and rejection letters to job applicants in which the presentation order is manipulated. The second experiment replicates the first, using a different medium (e-mail) and other instances of bad news. The results of both experiments indicate that readers perceive texts with the indirect order as more comprehensible and agreeable and its writer as more competent and empathic. Readers are also more inclined to comply with the decision in such texts when the explanation is presented first. [ABSTRACT FROM PUBLISHER]

The MUM effect refers to the robust research finding that people are more hesitant to share bad news relative to good news. An experiment utilized a false feedback test design to determine whether the MUM effect stems from a reluctance to share bad news, an eagerness to share good news, or both. Participants (N = 114) shared good, neutral, or bad news (i.e., high, medium, or low test scores) to a stranger. News valence, delay before response, and reluctance were measured. Delay before response and reluctance were linearly related to test score suggesting both eagerness to share good news and reluctance to share bad news. Practical and theoretical implications are discussed. [ABSTRACT FROM AUTHOR]

Delivering bad news to students, teachers, and parents is not an uncommon occurrence for school psychologists. Skillfully communicating bad news requires sensitivity, thoughtful wording, and an awareness of the potential effect on the recipients. Despite the importance of this skill, school psychology has devoted little attention to what is currently known about delivering bad news. This article synthesizes the literature on presenting and receiving bad news, devoting special attention to how information can be used by school psychologists in their day-to-day practices. Primarily drawn from medicine, the scholarship is instructive as a guide to the many dimensions of bad news delivery including what needs to be considered beforehand, how to communicate, cultural factors to consider, and conveying hope. [ABSTRACT FROM AUTHOR]

Goals Teaching delivery of bad news is part of the standard medical school curriculum. Lung cancer is a common disease with poor outcomes; therefore, "poor prognosis" discussions occur frequently. Trainee preparedness to conduct these has not been studied well to date. We surveyed residents treating lung cancer in Ontario, assessing preparedness to discuss a poor prognosis. Methods A 17-question survey was distributed to residents in medical oncology, palliative care, radiation oncology, respirology, and thoracic surgery. The survey questioned demographics, prior communication skills training, lung cancer knowledge, comfort in discussing a poor prognosis, and preferred approach to these consultations. Results Of 153 surveys distributed, 46% were completed. Most residents (68%) were Canadian trained and 70% were in the second-half of training. Lung cancer knowledge scores appear to be related to specialty (p=0.016); medical oncology residents scored higher (mean score 2.7/4) than other specialties (range 0-1.9). Comfort in discussing prognosis increased with years of training (p<0.0001). Observation of attending physicians was the preferred learning method (58%, p<0.0001). Similar numbers of residents preferred an optimistic or realistic approach in a poor prognosis consultation (49% versus 45%). Lung cancer knowledge, training location, specialty, age, gender, and level of comfort or preparedness in discussing bad news did not influence the approach taken by residents in a scenario of discussing a poor prognosis. Conclusion Comfort in discussing bad news improves with time. Residents rate observation the most useful tool in learning this skill. Efforts to enhance preparedness should include resident attendance and involvement in these consultations. [ABSTRACT FROM AUTHOR]

Objective Many breast cancer patients are troubled about telling their school-age children about their illness. However, little attention has been paid to the factors that encourage or discourage them from revealing the illness. This study explored decision-making by breast cancer patients about telling their children about their illness. Methods Participants were 30 breast cancer patients recruited from a regional cancer institution in Japan. Semi-structured interviews were conducted and content analysis was performed. Results Six preparatory stages of decision-making by Japanese breast cancer patients about telling their children about their illness were identified as follows: contemplation, preparation, action-hospitalization and surgery, action-adjuvant therapy, action-diagnosis, and action-prognosis. We also identified 11 categories of positive aspects and ten categories of negative aspects about revealing their illness to children. The categories of negative aspects with higher frequency were similar to those found by previous research, but categories of positive aspects were unique. The rate of reference to negative aspects in total reduces gradually as the preparatory stage advances, and in action-diagnosis and action-prognosis stages the balance between positive and negative aspects becomes about half and half. Conclusions Patients, especially in action-hospitalization and surgery, can be expected to tell their children about their illness although they find negative aspects much more compelling than positive aspects and experience great distress. These patients have special needs for support from others. [ABSTRACT FROM AUTHOR]

Communicating bad news is never easy and for physicians these interactions may be a significant source of stress. To examine the characteristics that make delivering of bad news stressful, two studies were conducted. In the first study, 37 physicians generated 192 responses describing the characteristics that influence how difficult it is to break bad news. After sorting the responses in terms of common themes, six categories were identified: Physician, Patient, Institutional, Illness, Relationship, and Mishap. In Study 2, 115 physicians rated the degree of stress associated with each factor. Using principle component and reliability analyses, empirical support was found for six categories. A higher-order factor analysis suggested the existence of one over-arching factor. Items in the Mishap category were rated on average as the most stressful. Stress scores were largely unrelated to years in practice, experience delivering bad news or training. [ABSTRACT FROM AUTHOR]

Aim: In curriculum documents for medicine in undergraduate, post-graduate and continuing professional development, there is now a focus on communication skills. The challenges are to place communication skills in the crowded curriculum and then to construct and sustain a programme that uses an evidence-based approach to the teaching and learning of communication skills. For 6 years, we have conducted a programme that involves simulated parents supporting junior medical staff to refine their skills in communication, particularly in giving parents bad news. The aim of our study was to obtain a better understanding of the trainees' experiences of the programme. Methods: Nine junior residents individually worked through two scenarios and received feedback from the simulated parent. They gave bad news to a simulated parent/actor who then gave feedback. A recording of the simulation was provided for discussion with a designated colleague at an arranged time. The tapes were then separately appraised by two independent raters – another actor and a paediatrician. Brief written reports and conducted semi-structured interviews provided more insights into the trainees’ experience of the simulation. Other participating medical/medical education staff were interviewed about the simulation programme. Results: Five themes emerged from the qualitative data: timeliness, emotional safety, the complexity of communication, practical usefulness and the challenge of effecting change. In addition, the ratings of the videos helped to clarify those ‘parent-centred’ communication skills that trainees may neglect in difficult conversations: ‘ask about support’, ‘encourage the parent to ask questions’ and ‘repeat key messages’. Conclusion: The evaluation highlighted the value of an early-career experiential programme to highlight the importance of communication skills in post-graduate paediatrics practice. [ABSTRACT FROM AUTHOR]

Materials and methods: An observational prospective and transverse study was performed in residents of the internal medicine program at the INCMNSZ. The questionnaire included 21 items that allowed the evaluation and categorization of the following aspects related to the delivery of bad news: previous information, first experience, emotional impact, accordance with basic concepts, communication with the patient, self-critical evaluation, personal experience, and willingness to receive training. Results: Fifty-six percent of the surveyed residents had never received information or training in bad news delivery; and only 8.0% communicated that they had received in their judgment an adequate or complete training, for the most part during medical school. Of the surveyed residents 96% considered that patients should know their diagnosis and prognosis; however, only 38.0% of residents referred having queried patients the extent to which they wished to know their prognosis. The majority reported disclosing the diagnosis directly to the patient; only 8% considered it correct to solely inform the responsible family member. Fifty-six percent of surveyed residents consider their capacity to deliver bad news as poor to regular. Of the surveyed residents 100% reported that they would like to be informed in case of terminal disease. Only 58.0% of surveyed residents have had an experience in receiving bad news and it had a positive impact on the majority of them. Eighty-percent of surveyed residents admitted that they needed training in this topic. Conclusions: As in other countries, this survey shows how training in bad news disclosure in Mexico is scarce among specialists. [ABSTRACT FROM AUTHOR]

Aims To ascertain the level of support and training available to paediatric specialist registrars (SpRs) in breaking bad news and their self-reported confidence in this task. Study design A questionnaire-based survey. Participants Paediatric SpRs working in North Thames region. Methods Specialist registrars ( n = 206) were sent a questionnaire relating to the level of support and training available to them in breaking bad news and their attitudes to this task. A repeat questionnaire was sent out 2 weeks later. Results The response rate was 54.9%. The study sample included 78 females and 34 males. The median year of qualification was 1995 [interquartile range (IQR) 1993–1997] and the median year of Calman training was Year 3 (IQR 2–4). Only 15.9% of participants had guidelines where they worked and 91.2% had received training in breaking bad news. Median self-perceived confidence in breaking bad news was rated as 4 out of 5. Only 21.2% of all respondents had both disclosed a diagnosis of Down syndrome and received feedback on their performance from their seniors. Few SpRs were able to adhere to all evidence-based recommendations for breaking bad news. Discussion Most SpRs had received training in breaking bad news and self-reported confidence in this skill was high, although their hands-on experience was limited. Recent research shows, however, that parental dissatisfaction with the way in which bad news is broken remains high. The potential discrepancy between self-reported confidence and actual competence casts doubt on the value of self-evaluation. [ABSTRACT FROM AUTHOR]

Good communication is a fundamental skill for all palliative care clinicians. Patients present with varied desires, beliefs, and cultural practices, and navigating these issues presents clinicians with unique challenges. This article provides an overview of the evidence for communication strategies in delivering bad news and discussing advance care planning. In addition, it reviews the literature regarding cultural aspects of care for terminally ill patients and their families and offers strategies for engaging them. Through good communication practices, clinicians can help to avoid conflict and understand patients' desires for end of life care. [ABSTRACT FROM AUTHOR]

People are reluctant to transmit bad news, a tendency named as the MUM effect. One explanation of this effect suggests that people do not want to construct negative impressions by being associated with bad news. In this study, transmission of good and bad news was examined from an impression management perspective. University students (N = 275) participated in a scenario study, with the valence of the news (good / bad) and outcome dependence on the recipient (high / low) as independent variables and transmission likelihood as dependent variable. Four variables, anticipated likeability, gratitude, perceived favor doing and ulterior motives, were assessed to form an ingratiation mediator. Results showed that participants were more likely to transmit good news than bad news. Also a significant interaction effect was obtained. In a high dependence condition participants were more likely to transmit good news and less likely to transmit bad news than participants in a low dependence condition. Moreover, the ingratiation construct significantly mediated the relationship investigated. In the second study (N = 74) similar findings were obtained except the interaction effect of dependence and news valence. [ABSTRACT FROM AUTHOR]

The reluctance to report bad news about a project and its status is a known problem in software project management that can contribute to project failure. The reluctance to report bad news is heightened when it bears personal risks. Oftentimes, those who report bad news end up losing face. In extreme cases, they not only lose face, but may end up on the unemployment line. The need to preserve face is a powerful influence on social behaviour. While universal, it manifests itself differently in different cultures. To date, there have been no empirical studies of the extent to which culturally constituted views of face-saving affect reporting of bad news on software projects. This is a particularly important topic given the increased prevalence of global, dispersed software development teams and offshore outsourcing of software development. In this study, we conducted a role-playing experiment in the USA and in South Korea, to investigate the effect of culturally constituted views of face-saving on the willingness to report bad news regarding a software development project. A blame-shifting opportunity was chosen as the means to operationalize face-saving in a culturally sensitive fashion. The two countries were chosen because they differ markedly in their views of face-saving and the relative importance ascribed to two important aspects of face: lian and mianzi. Results reveal that the presence of a blame-shifting opportunity had a significant effect on US subjects’ willingness to report bad news, but the effect on Korean subjects was not found to be statistically significant. In the absence of a blame-shifting opportunity, we did not observe any significant differences between US and Korean subjects in willingness to report bad news. The implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Breaking bad news is an extremely difficult and challenging process for the healthcare professional. The National Service Framework for Children in the UK highlights that the manner in which the healthcare professional delivers bad news impacts upon the way it is received, interpreted, understood and dealt with. The children's nurse, as an instrumental member of the multidisciplinary team caring for the child and family, is central to this complex communication process. This article examines the literature surrounding the breaking of bad news and introduces a new framework that outlines the multifaceted role of the children's nurse within this complex, challenging process. [ABSTRACT FROM AUTHOR]

The purpose of this investigation was to gain a better understanding of the transactional processes associated with communicating bad news. The authors asked 62 veterinarians to recall a time when they gave bad news and to respond to a series of statements designed to assess what they did in the transaction and how the transaction impacted the receiver of the news, as well as themselves. The majority of participants followed recommendations published in the medical and veterinary literatures, but rated some of these recommended strategies as making the news harder to give. Although these transactions were not rated as being overly stressful, for some veterinarians stress transcended the bounds of the interaction. Consistent with a transactional stress and coping perspective, preparation efforts were correlated with delivery efforts. However, preparation stress was unrelated to preparation or delivery efforts, and neither preparation efforts nor delivery efforts related to effectiveness appraisals or perceptions of client satisfaction. [ABSTRACT FROM AUTHOR]

In every medical specialty bad, sad, and difficult information must be given to patients and their families. An insensitive approach increases the distress of recipients of bad news, may exert a lasting impact on their ability to adapt and adjust, and can lead to anger and an increased risk of litigation. Many doctors also find these interactions stressful, and in the absence of much effective training they may adopt inappropriate ways of delivering bad news and coping with the emotional fall-out. Recognition of these difficulties has led to many initiatives, ranging from increased communication skills training to the development of guidelines and protocols. We review some of the research on the impact that giving sad, bad, and difficult news has on doctors and patients, and assess whether interventions are helping. We focus mainly on difficulties encountered involving parents in an obstetric or paediatric setting, people in acute trauma situations such as accident and emergency departments, and patients with cancer. [ABSTRACT FROM AUTHOR]

Focuses on a study which investigated how the individualism-collectivism dimension of natural culture may moderate the impact of organizational climate and information asymmetry on human predisposition to report bad news. Operationalization of organizational climate; Interaction between information asymmetry and individualism-collectivism; Implications for senior managers.

The article discusses the importance of communication skills in bad news delivery. It focuses on how healthcare practitioners deliver bad news particularly to HIV infected persons and examines the impact of the news to the lives of those diagnosed. Twenty-five HIV-positive respondents were interviewed and the data were coded and analyzed. Results showed that the delivery of bad news was critical to respondent's initial experiences with their diagnosis. Recommendations to HIV disclosure are enumerated, including educating healthcare professionals and assisting the patients in obtaining the information they need to cope with the disease. American Medical Association sponsored the "Education for Physicians on End-of-life Care" (EPEC) program to recognize the importance of communication skills.

Breaking bad news is one of a physician's most difficult duties, yet medical education typically offers little formal preparation for this daunting task. Without proper training, the discomfort and uncertainty associated with breaking bad news may lead physicians to emotionally disengage from patients. Numerous study results show that patients generally desire frank and empathetic disclosure of a terminal diagnosis or other bad news. Focused training in communication skills and techniques to facilitate breaking bad news has been demonstrated to improve patient satisfaction and physician comfort. Physicians can build on the following simple mnemonic, ABCDE, to provide hope and healing to patients receiving bad news: Advance preparation--arrange adequate time and privacy, confirm medical facts, review relevant clinical data, and emotionally prepare for the encounter. Building a therapeutic relationship-identify patient preferences regarding the disclosure of bad news. Communicating well--determine the patient's knowledge and understanding of the situation, proceed at the patient's pace, avoid medical jargon or euphemisms, allow for silence and tears, and answer questions. Dealing with patient and family reactions--assess and respond to emotional reactions and empathize with the patient. Encouraging/validating emotions--offer realistic hope based on the patient's goals and deal with your own needs. [ABSTRACT FROM AUTHOR]

The factors that affect the latency period between attracting a target person's attention and delivering either good or bad news were examined. The subjects were 66 (34 female, 32 male) Canadian university students. Three hypotheses were confirmed: There was a longer latency period for bad news than for good news, women had a longer latency period for bad news than for good news and a longer latency period for delivering either bad news or good news than men did, and there was a longer latency period when women delivered bad news to a man than when women delivered bad news to a woman. [ABSTRACT FROM AUTHOR]

Suggests techniques that can be used in teaching physicians to deliver bad news. Interaction within a small group; Significance of demonstration and role modeling to participants; Exercises to combine skills and effective training.

Discusses layers of the morality of bad and good news. Ways in which crediting messengers of good or bad news appears to be a preferred or structurally valued conversational activity; Examination of episodes of bad news and good news in ordinary conversation; Differences in moral discourse or ways in which participants in their communicative acts approach agency and responsibility.

Explores the conditional nature of good and bad news and ways in which good news is privileged over bad news in conversational interaction. Presentation of information as an account or as news; Components of a news delivery sequence (NDS); Conditions that allow for events and information to become news-of-a-particular-kind; Role of endogenous orderliness in actual interactional practices.

Offers guidelines on breaking bad news to patients. General principles in breaking bad news; Specific steps for breaking the news; Important way to determine the appropriateness of guidelines for conveying bad news.

Forecasting is a strategy for delivering bad news and is compared to two other strategies, stalling and being blunt. Forecasting provides some warning that bad news is forthcoming without keeping the recipient in a state of indefinite suspense (stalling) or conveying the news abruptly (being blunt). Forecasting appears to be more effective than stalling or being blunt in helping a recipient to "realize" the bad news because it involves the deliverer and recipient in a particular social relation: The deliverer of bad news initiates the telling by giving an advance indication of the bad news to come; this allows the recipient to calculate the news in advance of its final presentation, when the deliverer confirms what the recipient has been led to anticipate. Thus, realization of bad news emerges from intimate collaboration, whereas stalling and being blunt require recipients to apprehend the news in a social vacuum. Exacerbating disruption to recipients' everyday world, stalling and being blunt increase the probability of misapprehension (denying, blaming, taking the situation as a joke, etc.) and thereby inhibit rather than facilitate realization. Realization and lack thereof are features of social psychology; social practices and interactional organization are implicated in individual cognition. My data include more than I00 narratives about the delivery and receipt of bad news. [ABSTRACT FROM AUTHOR]

Occupations differ in me frequency with which their performers must communicate bad news to a serviced public. At one extreme, bad news must be communicated several times a day, day after day. One such occupation, the deputy U. S. Marshal, is analyzed in terms of tactics employed to manage the stressful moments of preparing to deliver bad news, delivering it, and shoring up recipients after delivery. Detailed tactics described include distancing, presaging, treating as routine, manipulating the message, and displaying certain supportive attitudes in interaction. [ABSTRACT FROM AUTHOR]

This article presents information on the analytic treatment of a single-episode of talk-interaction as a mechanism for steering recipients of bad news to better guesses of what the news is. "Rejection" of guesses at bad news is done as a preferred response--i.e., quickly and not delayed--when the "actual news" is "not as bad" as the guess. "Rejection is done as a dispreferred response when the actual news is worse than the guess--when the guess is not bad enough, is too optimistic. The evidence that the device operates in this manner for the members is of the following sort. If a guess is rejected, then one possible sequel is that another guess be proffered. If the last guess was rejected as a preferred rejection, i.e., quick, thus showings according to the conjecture that the actual news is not as bad as the guess, then the next guess displays an under standing of that by being a less bad guess, by being more optimistic if the rejection was done as dispreferred as delayed, then the guesser's understanding is displayed by a next guess being "worse." The result is that by rejecting guesses more or less quickly or sIowly, the bearer of bad tidings can "steer" the intended recipients who are trying to guess the news in the right direction," i.e., toward better guesses.

This research represents a continuation of efforts to examine the area of bad news delivery and focuses on the messages and subsequent strategies used by people in delivering news of a desire to terminate an intimate relationship. The lack of well-defined, normative guidelines for such deliveries adds to the problematic nature of the interaction. Based on indepth, unstructured interviews, a framework based on common themes providing a procedural view of the delivery process was constructed. Discussion of various strategies indicated the significance of situational factors in delivering this type of bad news. The study, almost exploratory in nature, will hopefully clarify some of the processes involved in the delivery of news of a desire to involved in the delivery of news of a desire to terminate a relationship and identify several important problems surrounding this complex and serious form of interaction. [ABSTRACT FROM AUTHOR]