REVIEW   Free access

Minerva Forensic Medicine 2022 June-September;142(2-3):37-45

DOI: 10.23736/S2784-8922.22.01819-2

Copyright © 2022 EDIZIONI MINERVA MEDICA

lingua: Inglese

End-of-life: let’s talk about communication

Rossana CECCHI ¹ ✉, Matilde SASSANI ², Francesco S. ROMOLO ³, Nicole TESTON ¹, Alessandra SANNELLA ⁴

¹ Institute of Legal Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy; ² Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; ³ Department of Law, University of Bergamo, Bergamo, Italy; ⁴ Department of Human and Social Sciences, University of Cassino, Cassino, Frosinone, Italy

INTRODUCTION: The aim of the present work was to analyse the role played by communication in the medical-health intervention and how to transform it in a practical support for the health professions and the patient’s outcome.
EVIDENCE ACQUISITION: Through a review of the literature the meaning of bad news is analyzed and the main models aimed at helping doctors and health care teams communicate the bad news (the NURSE protocol, the PERCS protocol and the SPIKES protocol) are described.
EVIDENCE SYNTHESIS: Starting from the meaning of bad news and the communication models available, authors discuss the impact of bad news on the patient, on the doctor and underline the need for the teaching of communication for doctors and degree students, as well as the need for training in communication with the patient.
CONCLUSIONS: The complexity of the doctor-patient relationship implies communicative exchanges, in which the effectiveness of the information provided by the doctor depends on the emotions felt in communicating it, and the understanding of what is communicated depends on the patient’s emotional state. It appears urgent, therefore, to create a training path that stems from the standardization of the results obtained from sector studies and that aims to replicate the socio-health practices considered to be of excellence. The communication effectiveness is indispensable for an adaptation process that expresses the citizen’s ability to adapt to changes in the environment, to grow and age, to heal after a sickness, and to suffer and wait, more possible serenely, the death.

KEY WORDS: Terminal care; Truth disclosure; Health communication