Measuring Attitude and Practice of Physician toward Breaking Bad News to the Breast Cancer Patients:Development and Validation of a Questionnaire

Background: Breaking bad news to cancer patients is one of the importantresponsibilities in the oncology setting. The purpose of this study is develop andvalidate a new theoretically based tool for measurement of attitude and practice ofphysicians toward breaking bad news.Methods: The psychometric properties of the scale were established by followingthe guidelines of Clark andWatson. In the first phase, a literature review was performedto create items; then items were assessed for content validity through individualinterview (n = ۱۲) and construct validity was assessed by using factor analysis.Reliability was evaluated by Cronbach’s alpha. Research data was gathered fromphysicians working in breast cancer setting.Results: A total of ۱۲ expert reviews concluded that a large amount of items ofattitude and practice questionnaires were important and essential (Content ValidityRatio > ۰.۷۳). The exploratory and confirmatory factor analyses for a sample ofphysicians (n = ۲۰۰) indicated a ۱۲-item of attitude scale with three factors: fulldisclosure, non-disclosure and individual disclosure. Cronbach’s Alpha for the factorsreturned ۰.۷۴۶, ۰.۸۳۴ and ۰.۷۹۵, respectively. The exploratory and confirmatory factoranalyses for a sample of physicians (n = ۲۰۰) indicated a ۲۰-item of practice scale withsix factors: preparation, setting of the interaction, communicate well, use of the “cancer”word, patient’s right to know and close the interview, and summarized. Cronbach’sAlpha for the factors returned ۰.۷۶۵, ۰.۶۳, ۰.۶۵, ۰.۷۹۳, ۰.۷۵۹ and ۰.۷, respectively.Conclusions:Aresultant ۱۲ items of attitude and ۲۰ items of practice questionnairewere developed to assess how physicians are giving bad news to breast cancer patients.The reliability of the new tools needs to be evaluated for further studies. This newquestionnaire will provide researchers and clinicians with a thorough and suitableinstrument to measure belief and practice regarding disclosing the truth to breast cancerpatients.

Keywords:

Physician , bad news , telling truth , psychometric , questionnaire development