ABSTRACT
Breaking bad news is one of doctors’ duties and it requires them to have some skills, given that this situation is difficult and distressful for patients and their families. Moreover, it is also an uncomfortable condition for doctors. The aim of this study was to evaluate doctors’ capacity to break bad news, ascertain which specialties are best prepared for doing this and assess the importance of including this topic within undergraduate courses. Design and Setting: Observational cross-sectional quantitative study conducted at Vardhman Institute of Medical sciences, Nalanda, India. Methods: This study used a questionnaire based on the SPIKES protocol, which was answered by 121 doctors at this university hospital. This questionnaire investigated their attitudes, posture, behavior and fears relating to breaking bad news. Results: The majority of the doctors did not have problems regarding the concept of bad news. Nevertheless, their abilities diverged depending on the stage of the protocol and on their specialty and length of time since graduation. Generally, doctors who had graduated more than ten years before this survey felt more comfortable and confident, and thus transmitted the bad news in a better conducted manner. Conclusion: Much needs to be improved regarding this technique. Therefore, inclusion of this topic in undergraduate courses is necessary and proposals should be put forward and verified.
ABSTRACT
Background: Psoriasis and depressive disorders commonly occur together. Depressive disorders have an impact on the quality of life and the outcome of psoriasis. Aims: The aim of this study was to test the feasibility of using a modifi cation of the Hindi translation of the Patient Health Questionnaire-9 (PHQ-9) as a verbal, clinician administered, short screening questionnaire for detecting depressive disorders. Materials and Methods: One hundred and four out-patients with psoriasis were recruited in the study. In the fi rst stage of the study, socio-demographic data, Psoriasis Area Severity Index (PASI) score, and Dermatological Quality of Life (DLQI) score were recorded. The modifi ed questionnaire was administered by the dermatologist. In the second stage, psychiatric diagnoses were confi rmed using the Mini International Neuropsychiatric Interview. Results: The prevalence of depressive disorders was 39.4%. Receiver operating curve (ROC) analysis showed that the questionnaire had a good discriminant ability in detecting depressive disorders (area under curve: 0.81, SE = 0.04, 95% confi dence interval = 0.72–0.89). Limitations: The sample size is small and more studies are needed with the screening questions in different languages to validate the fi ndings of the study. Conclusion: The questionnaire can be a useful screening instrument for detecting depressive disorders in patients with psoriasis.