Developing an Iranian protocol for breaking bad news to cancer patients: A modified Delphi study

Introduction & aim: Evidence has shown that the existence of localized patterns for bad news disclosure in the Western countries as well as training of the healthcare team members for their implementation has had a significant impact on the patients’ greater satisfaction from diagnosis disclosure, easier acceptance of the disease, and even less psychological side effects. In Iran, there is still no guideline for bad news disclosure to the patients, and this is why the present study aimed to develop a localized protocol for disclosure of bad news to cancer patients.Methods: In this study, the modified Delphi technique was manipulated in a three rounds to develop the protocol for bad news disclosure. The first round was done in the form of a qualitative study. Then, the findings from the first round were made richer through review of the relevant literature; and finally, a survey was conducted in the following rounds through developing a questionnaire.Results: Based on the findings obtained through various rounds of Delphi, a protocol was developed which contained six steps for bad news disclosure of cancer diagnosis to the patients and their family members. The steps in this protocol are: assessment, planning, preparation, disclosure, support and conclusion.Conclusion: Considering the specific cultural perspectives of the Iranians towards cancer taboo, some provisions were included in the protocol which not only cannot be found in the Western protocols, but in some cases are even contradicts with them. Such findings reflect the importance of development and implementation of such a localized protocol for bad news disclosure to the patients.