Perspectives of psychologists working in hospitals on the use of protocols for communicating bad news

Abstract

Introduction: Communication is a fundamental resource in healthcare, as it strengthens bonds, develops patient autonomy, and improves trust through the doctor-patient relationship. However, communicating is not considered a simple or easy action, as it relates to beliefs, values, and principles that can interfere with the transmission of information. Objective: The objective of this study was to understand the perspectives of hospital psychologists on the use of protocols for communicating bad news in the hospital environment by the medical team. Materials and methods: This is a descriptive, cross-sectional study of a qualitative nature with descriptive quantitative support. The proposed approach used “snowball sampling”, a non-probabilistic technique in which initial study participants indicate new participants from their own networks of contacts. A "Sociodemographic and Professional Questionnaire" was used, followed by a "Semi-structured Interview Guide," to collect data in order to generate quantitative data analyzed using descriptive statistics, with calculations of frequency, mean, and percentage, and qualitative data analyzed according to Bardin's Content Analysis. Results and discussion: The sample consisted of 27 psychologists working professionally in hospitals in the state of Rio de Janeiro. The results revealed a predominance of female professionals (67%). The majority were between 31 and 40 years old (41%), more than half had postgraduate degrees in Hospital Psychology (56%), had been practicing for between 2 and 10 years (67%), and a large proportion worked in the public sector (78%). Regarding protocols for communicating bad news, 55% of participants stated that they were familiar with them; however, only 26% of participants observed their use by the medical team. The interviews resulted in four thematic categories: "Knowledge about the protocols"; "Appropriate ways to communicate bad news"; "Inappropriate ways to communicate bad news"; and "Professional training and development". Conclusion: The results showed a discrepancy between theoretical knowledge and practical application of the protocols, reinforcing the need for continuous training of medical teams and, if possible, the participation of a hospital psychologist in moments of communicating bad news in the hospital environment.