ECREA16-Abstract

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Thursday, November 10

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ICS02

CommunicatingHealth

PP 249

Doctors Breaking Bad News and Talking About Death

T.M. Artkoski

, M.L. Hyvärinen

University of TampereCMT, CMT, Tampere, Finland

University of Eastern Finland, Kuopio, Finland

As a philosophical question, death has been a captivating theme from the early times of humanity. Nevertheless, man has a natural thrive to shut unde‑

sirable and elusive matters out. Death has nowadays been detached to hospitals and other institutions, therefore making it easy to forget. However, death

is always present in the medical doctor’s profession. Breaking bad news and speaking about death is closely intertwined with the work of doctors. What is

meant by breaking bad news is a situation where a patient’s physical or mental situation has acutely deteriorated e.g. because of a severe illness, an accident

or an unsuccessful operation. To whom he is talking and how does he talk about it? What kind of experiences are breaking bad news and talking about

death to the doctor?Will a doctor ever get used to discussing these matters? Can talking about death be a routine task, which is simply a part of the job? Or

is it possible for a doctor to avoid discussions of these themes? A cancer patient is an example of those patients, with whom the doctor-patient relationship

might become prolonged, and in those circumstances the doctor has to face the emotional reactions to and fear of death. This article is based on a qualita‑

tive research. 27 doctors, who talked about their subjective experiences and opinions about informing bad news and talking about death, were interviewed

for the research. The doctors represent different sectors of health care as well as eight subspecialties. The article describes what kind of experiences telling

bad news and handling the theme of death are to the doctor, and further how they behave in these situations. The results can be utilized in the interaction

education of the doctors and also generally on the area of health care, when practical procedures how to handle these sensitive issues are being developed.

The results show that talking about death is a central theme connected with breaking bad news.The doctors prefer a fact-oriented way of acting and a frank

style of discussing the possibility of death with the patient or the relatives. It is typical that after doctor has shared the bad news, the patients/relatives will

state questions about the prognosis, the effectiveness of treatments and the probability of death, to which questions the medical expert is expected to give

answers. In these situations, one of the most important tasks is to encounter and handle the emotional reactions of the patients/relatives. However, break‑

ing bad news and talking about death are difficult jobs for the doctor. One part of the doctors consider talking about death to be so difficult and emotionally

burdening that they avoid speaking about it or advance handling of the topic further to a nurse or another specialist. Therefore in the medical education

the doctors should be trained to speak about death to the patients and their beloved ones, and further deal with the strong emotional experiences arising

from breaking bad news. Keywords: breaking bad news, death, doctor, education, emotions, patient

PP 250

Intergroup Contact and the Issue of Vaccination in a Facebook Group: A Longitudinal Study About the Effects on Intergroup Attitudes

E. Malinaki

, E. Kioumi

, A. Gardikiotis

Aristotle University of Thessaloniki, School of Journalism and Mass Media, Thessaloniki, Greece

Nowadays, a growing number of people think of vaccination as a risky health behavior due to the fear of injecting a foreign substance into the body that

could introduce new harms rather than do well. While vaccination in many studies is considered as an increasingly common preventive health behavior,

many people report that vaccination involves some level of discomfort and consider it to be an ambiguous health behavior due to the relative perceived

health risks.The rise of social media seems to have created a new space for communication and exchange of opinions on different kind of issues from politics

to health. As Postmes, Spears and Lea (2002) point out the Internet has the ability to “break” the barriers of ethnicity, race, language and ideology. This

seemingly positive outcome is contradicted by the SIDE model (social identity model of deindividuation effects), which suggests that in the newmedia con‑

text the anonymity provided may in fact lead to polarisation and radical decisions in comparison to face-to-face communication (Reicher, Spears & Postmes,

1995; Spears & Postmes, 2015). At the same time, health communication plays a crucial role in shaping people’s decisions to engage in particular health

behaviors. Today, people tend to discuss health issues and personal decisions online. The purpose of our study is to determine whether the contact between

members of groups who support different health issues may have an effect on their intergroup attitudes. Research has shown that intergroup contact is

negatively related to prejudice (Brown & Hewstone, 2005); direct and extended contact relate to intergroup attitudes (Wright, Aron, McLaughlin-Volpe &

Ropp, 1997); and moderator (such the typicality of the outgroup member,Turner, Hewstone,Voci &Vonofakou, 2008) or mediator variables (such intergroup

anxiety, see Hogg & Vaughan, 2008) affect the relationship between contact and attitudes (Pettigrew & Tropp, 2006). For the purpose of our research,

we created a Facebook group and invited users of the specific social media to join and post articles, comments, discuss and exchange experiences and

information. The purpose of the group was to provide a space for dialogue between supporters and adversaries of vaccinations on children and adults.

More than 150 people joined the group, but less than half completed the questionnaires and less than 15 percent of the members actively participated in

the discussions. Specifically, during the period that the groups were active, the participants completed three different questionnaires. 68 people completed

all the questionnaires, the majority of which was female (F: 52 M: 16), and from those who completed the questionnaires more where pro vaccinations (pro:

47, against: 21). So far, our study has taken into account the particular characteristics of communication over the Internet and the new media that may af‑

fect intergroup attitudes: e.g., greater sense of anonymity and increased tendency for self-disclosure (Amichai-Hamburger & McKenna, 2006). At the same

time, a number of predictors of intergroup attitudes such as quality of intergroup contact, experienced anxiety, self-disclosure and inclusion of outgroup in

the self, extended contact, affect reactivity were measured (Harwood, 2010).