Türkiye’de Hekimlerin Kötü Haber Vermeye Yönelik Tutumları

Öz

Amaç: Tıbbi iletişimde kötü haber, hastanın geleceğine dair bakışını önemli ölçüde değiştirebilecek bilgiler olarak tanımlanır. Hekimler, bu tür haberleri sıklıkla ileten kişiler olup, bu süreç hem hastalar hem de hekimler için duygusal açıdan zorlayıcı olabilir. Ayrıca, kötü haber verme tutumları ve bu konudaki beceriler hekimler arasında farklılık gösterebilir. Bu çalışmada hekimlerin kötü haber vermeye ilişkin tutumlarını incelemeye yönelik geliştirilen 15 maddelik Kötü Haber Verme Tutumları Ölçeği’nin (KHVTÖ) Türkçe geçerlik ve güvenirlik çalışması yapılmış ve hekimlerin kötü haber vermeye ilişkin tutumlarının belirleyicileri anlaşılmak istenmiştir. Yöntem: Çalışma kapsamında Selçuk Üniversitesi Tıp Fakültesi’nde görev yapmakta olan 203 hekime ve ileri sınıf Tıp Fakültesi öğrencisine (111 kadın, 92 erkek) ulaşılmıştır. Bulgular: Analizler sonucunda 1 madde düşük faktör yükü, 2 madde de çoklu doğrusal bağlantıyı azaltmak amacıyla çıkarılmış ve 12 maddelik 2 boyutlu (kötü haberlerin verilmesine yönelik tutumlar, kötü haber vermeye ilişkin eğitim almaya dair tutumlar) Türkçe formun veriye iyi bir uyum sağladığı görülmüştür. İki boyutun iç tutarlılık katsayıları (Cronbach α=,81 ve ,82) da ölçeğin Türkçe formunun güvenilir olduğuna işaret etmektedir. Ölçeğin yapı geçerliğini incelemek adına ilişkili olabileceği düşünülen ölçüm yöntemleriyle ilişkisi incelenmiş ve ölçeğin kişilerarası iletişim yetkinliği ve genel öz yeterlik ile pozitif yönde, algılanan stres ile ise negatif yönde ilişkili olduğu görülmüştür. Bu bulgular ölçeğin Türkçe formunun geçerli ve güvenilir bir ölçüm yöntemi olduğuna işaret etmektedir. Sonuç: Sonuçlar hekimlerin kötü haber vermeye ilişkin tutumlarına, bu tutumları teşvik eden ve önünde engel oluşturan faktörlerin anlaşılmasına ışık tutmaktadır.

Anahtar Kelimeler

• gerçeği açıklama
• kötü haber iletimi
• öz yeterlik
• empati
• psikolojik stres
• iletişim
• doktor-hasta ilişkileri

Attitudes Toward Breaking Bad News Among Physicians in Türkiye

Öz

Objective: In medical communication, bad news is conceptualized as any information that can significantly alter patient’s outlook on their future. Physicians are often the ones responsible for delivering such news, and this process can be emotionally challenging for both patients and doctors. Moreover, attitudes toward breaking bad news and the skills involved in doing so may vary among physicians. This study’s main aim is to investigate physicians’ attitudes toward delivering bad news through conducting the Turkish validity and reliability analysis of the 15-item Breaking Bad News Attitudes Scale (BBNAS). The study also sought to identify the key predictors of physicians’ attitudes on breaking bad news. Method: A total of 203 physicians and senior medical students (111 women, 92 men) working at Selçuk University Faculty of Medicine participated in the research. Results: As a result of the analyses, one item was removed due to low factor loading, and two items were excluded to reduce multicollinearity. The final 12-item Turkish version, consisting of two dimensions (SPIKES Adherence and BBN Training) demonstrated a good model fit. Internal consistency coefficients (Cronbach’s α=.81 and .82) for the two dimensions indicated that the Turkish form of the scale is reliable. To assess construct validity, correlations were examined with related measures. The scale was found to be positively associated with interpersonal communication competence and general self-efficacy and negatively associated with perceived stress. This study’s results indicated that the Turkish form of BBNAS is a valid and reliable measure for evaluating medical doctors’ breaking bad news attitudes. Conclusion: The results shed light on physicians’ attitudes toward breaking bad news and on the factors that facilitate or hinder these attitudes.

Anahtar Kelimeler

• truth disclosure
• breaking bad news
• self efficacy
• empathy
• psychological stress
• communication
• physician-patient relations

Kaynakça

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