Research Article

EFFECTIVENESS OF TRAINING WORKSHOP ON THE ATTITUDE OF HEALTHCARE PROVIDERS TOWARDS BREAKING BAD NEWS TO CANCER PATIENTS: A MULTI- INSTITUTIONAL STUDY

Samuel A. Otene1*, Shehu Salihu Umar2, Ali Abba Tijjani3, DA Bojude D4, Foluke O. Sarimiye5, Sani B. Abubakar6, Vitalis C. Okwor7, Emmanuel Aimebelomo Ikhile8, Auwal G. Suleiman9, Suleiman K. Hamidu10, Vivian C. Nwordu11, Nwamaka Lasebikan11, Musa Ali-Gombe11, Usman M. Aliyu11
1 Federal University of Health Science, Otukpo, Benue State, Nigeria.
2 Department of Radiology, Ahmadu Bello University Zaria, Kaduna State, Nigeria
3 Department of Radiology, University of Maiduguri, Maiduguri, Borno State, Nigeria; Department of Clinical Oncology, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
4 Radiotherapy and Oncology Department, Federal Teaching Hospital Gombe, Nigeria
5 Department of Radiation Oncology, University of Ibadan/University College Hospital (UCH), Ibadan, Oyo State, Nigeria
6 Department of Haematology and Blood Transfusion, Usman Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria.
7 Department of Radiation and Clinical Oncology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria.
8 University of Benin Teaching Hospital
9 Department of Community Medicine, College of Medical Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
10 National Institute for Cancer Research and Treatment (NICRAT), 43 Agadez Crescent, Wuse II, 900288, FCT-Abuja, Nigeria
11 National Institute for Cancer Research and Treatment (NICRAT), 43 Agadez Crescent, Wuse II, 900288, FCT-Abuja, Nigeria.
* Corresponding author: sammy4ng@yahoo.com
Published: Jul, 2025
DOI: 10.67579/njo.2025.qe8i4g5m
Pages: 220-233
Views: 236
Downloads: 133

Abstract

Background: Breaking bad news (BBN) is a critical aspect of oncology care. Unfortunately, many healthcare providers (HCPs) in Nigeria lack formal training in this skill.


Objective: This study evaluated the effectiveness of a training workshop on HCPs’ attitudes towards BBN to cancer patients across multiple institutions in Nigeria.


Methods: A quasi-experimental study was conducted across six federal hospitals in Nigeria, representing the country’s six geopolitical zones. A total of 632 HCPs (doctors, nurses, and other professionals) were trained over 3 days on BBN, using didactic lectures, role play, group discussions, and interactive sessions. The SPIKES model and other communication strategies were emphasized. Attitudes towards BBN were assessed before and after training via an 8-item Likert scale. The data were analysed via SPSS v25, with statistical significance set at p<0.05.


Results: A total of 590 participants completed the pre-test, and 528 completed the post-test. Before training, 60.8% of the participants had never received formal BBN training, although 68.5% frequently engaged in BBN. Post training, there was a statistically significant improvement in confidence, understanding of communication models, and ability to handle patients’ emotional reactions (p<0.0001). The attitude scores improved across all geopolitical zones and professional categories.


Conclusion: A structured BBN training workshop significantly improved healthcare providers’ attitudes toward delivering bad news to cancer patients. The incorporation of such training into medical curricula and continuing professional education can enhance patient-provider communication and emotional support in oncology settings.


Keywords

Cancer communication Psycho-Oncology Breaking Bad News SPIKES Model.

References

  1. Miniahidashti H, Mousavi SJ, Darzi MM. Patients’ Attitude toward Breaking Bad News; a Brief Report. Emergency. 2016;4(1):34-37
  2. Mulugeta T, Alemu W, Tigeneh W, et al. Breaking bad news in oncology practice: experience and challenges of oncology health professionals in Ethiopia – an exploratory qualitative study. BMJ Open 2024;14: e087977.
  3. Monden KR, Gentry L, Cox TR. Delivering bad news to patients. Proc (Bayl Univ Med Cent). 2016;29(1):101-2.
  4. WF Baile, R Buckman, R Lenzi, G Glober, EA Beale, AP Kudelka. SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer the Oncologist 2000; 5:302-311
  5. RA Buckman. Breaking bad news: the S-P-I-K-E-S strategy. Commun Oncol 2005; 2:138– 142
  6. Monden KR, Gentry L, Cox TR. Delivering bad news to patients. Proc (Bayl Univ Med Cent). 2016 Jan;29(1):101-2.
  7. Narayanan V, Bista B, Koshy C. 'BREAKS' Protocol for Breaking Bad News. Indian J Palliat Care. 2010 May;16(2):61-5.
  8. M Bumb, J Keefe, L Miller, J Overcash. Breaking Bad News An evidence-based review of communication models for oncology nurse. Clinical Journal of Oncology Nursing 2017;21(5): 573- 580
  9. David Velez, Andrea Gerberding, Mentor Ahmeti - SUNBURN: a protocol for delivering bad news in trauma and acute care surgery: Trauma Surgery & Acute Care Open 2022;7: e000851.
  10. Kumar V, Sarkhel S. Clinical Practice Guidelines on Breaking Bad News. Indian Journal of Psychiatry 2023;65(2): p 238-244.
  11. Aminiahidashti H, Mousavi SJ, Darzi MM. Patients’ Attitude toward Breaking Bad News; a Brief Report. Emergency (2016); 4 (1): 34-37
  12. I Okoye, S Otene, A Aniarodo, DU Ejoh, VC Okwor, EO Akin-Odanye et al. Breaking the bad news of cancer: Exploring patient–doctor communication among clinical oncologists in Nigeria. JCO 2024;42: e23251-e23251
  13. AA Woldemariam, R Andersson, C Munthe, B Linderholm, N Berbyuk Lindstrom. Breaking Bad News in Cancer Care: Ethiopian Patients Want More Information Than What Family and the Public Want Them to Have. JCO Global Oncol 7:1341-1348
  14. Lounsbury DW, Nichols S, Asuzu C, Odiyo P, Alis A, Qadir M, et.al. Communicating bad news to patients and families in African oncology settings. Psychooncology. 2023;32(1):47-57.
  15. L Francis, N Robertson. Healthcare practitioners’ experiences of breaking bad news: A critical interpretative meta synthesis. Patient Education and Counselling 2023; 107: 107574.DOI [https://doi.org/10.1016/j.pec.2022.107574](https://www.google.com/search?q=https://doi.org/10.1016/j.pec.2022.107574)
  16. C Primeaua, M Chau, MR Turner, C Paterson. Patient Experiences of Patient Clinician Communication among Cancer Multidisciplinary Healthcare Professionals During “Breaking Bad News”: A Qualitative Systematic Review. Semin Oncol Nurs. 2024; 40(4): 151680.doi: 10.1016/j.soncn.2024.151680
  17. Adebayo PB, Abayomi O, Johnson PO, Oloyede T, Oyelekan AA. Breaking bad news in clinical setting - health professionals’ experience and perceived competence in Southwestern Nigeria: a cross-sectional study. Ann Afr Med. 2013;12(4):205-11.
  18. Yousuf AAAA, Stewart DC, Kane T, Soltani A, Al-Khal A and Sethi A (2024) Health professionals’ views and experiences of breaking bad news in the Eastern Mediterranean Region: a scoping review. Front. Med. 2024;11:1440867.
  19. BN Nabi, ZR Sorouri, A Pourramzani, SH Mirpour, G Biazar, Z Atrkari. Physicians’ Skills in Breaking Bad News to Patients with Cancer Using SPIKES Protocol. Caspian J Neurol Sci 2022; 89(4): 234- 243.
  20. Mansoursamaei M, Jolfaei AG, Zandi M, Mansoursamaei A, Salehian R. Self-assessment of residents in breaking bad news; skills and barriers. BMC Medical Education 2023; 23:740-748
How to Cite

Otene, S. A., Umar, S. S., Tijjani, A. A., D, D. B., Sarimiye, F. O., Abubakar, S. B., Okwor, V. C., Ikhile, E. A., Suleiman, A. G., Hamidu, S. K., Nwordu, V. C., Lasebikan, N., Ali-Gombe, M., & Aliyu, U. M. (2025). EFFECTIVENESS OF TRAINING WORKSHOP ON THE ATTITUDE OF HEALTHCARE PROVIDERS TOWARDS BREAKING BAD NEWS TO CANCER PATIENTS: A MULTI- INSTITUTIONAL STUDY. Nigerian Journal of Oncology, 1(2), 220-233. https://doi.org/10.67579/njo.2025.qe8i4g5m

S. A. Otene, S. S. Umar, A. A. Tijjani, D. B. D, F. O. Sarimiye, S. B. Abubakar, V. C. Okwor, E. A. Ikhile, A. G. Suleiman, S. K. Hamidu, V. C. Nwordu, N. Lasebikan, M. Ali-Gombe, and U. M. Aliyu, "EFFECTIVENESS OF TRAINING WORKSHOP ON THE ATTITUDE OF HEALTHCARE PROVIDERS TOWARDS BREAKING BAD NEWS TO CANCER PATIENTS: A MULTI- INSTITUTIONAL STUDY," Nigerian Journal of Oncology, vol. 1, no. 2, pp. 220-233, July 2025. doi: 10.67579/njo.2025.qe8i4g5m

Share this article:
Facebook X / Twitter LinkedIn
Download PDF View Full Text (PDF) Back to Articles