Bad news has been widely studied. There is also another type of negative information that is linked with illness trajectory and treatment which can lead to distress. This sort of message is known as Micro-Bad News (MBN) and has been studied in hematological patients, demonstrating that daily events are paramount to increasing distress in such patients. The aim of this survey is to detect MBN within daily communication between oncologist and inpatients with phase IV-cancer diagnosis, and to infer the patient´s perception of what negative information is and which type they find more distressful. Based on a previous research, the following categories of MBN have been used: information about Physical Harm, threatening patient´s Private Sphere, generating or not solving Uncontrollability and Promoting Ambiguity.
METHODS. During morning wards, we assessed daily communication, which affects patients adversely, and registered its frequency, content, predictability, newness and degree of distress.
RESULTS. The survey comprises 914 doctor-to-patient interactions, of which 41 MBN (4,4%) were observed. Out of the 191-patient sample, 18% had received a piece of MBN at some point, and 2,1% had received more than one. The average value for the moment a piece of MBN was given, was day No. 8 (range: day#1-day#21), and SD 5,71. The reported distress mean value was 6,59% (1-10 range), and SD 2,69. No significant differences between MBN regarding gender, diagnosis, hospitalization length, age, nor regarding their contents, were observed.
CONCLUSION. The findings indicate that, in this study, patients presented less amount of MBN compared with previous studies. Nevertheless, the average distress reported by them is rather high, proving how relevant MBN are in the increase of perceived distress. From all the MBN referred to by the patients, none belonged to the Promoting Ambiguity category.