Objective: To study and explore problems perceived by physicians when breaking bad news
to advanced cancer patients about discontinuing or not offering tumor-specific treatment due
to incurable cancer.
Design: A qualitative phenomenographic interview study.
Setting: The county of Östergötland in Sweden.
Participants: Thirty physicians with different demographic characteristics.
Results: According to the physicians' answers breaking bad news was perceived as involving
a risk of losing control in different ways, regarding emotions, oneself, confidence,
professionalism and patient trust. Four different main categories described as problems were
identified; perceptions focusing on existential thoughts, relationships, knowledge, and perceptions
related to time and environmental disturbances.
Conclusion: Physicians perceived that breaking bad news to dying patients with cancer involved
a risk of losing control. Existential thoughts and a lack of knowledge contribute to
this risk. Theoretical education in existentiality/spirituality and clinical practice in a palliative
context may help maintaining control.
