A comunicação de uma má notícia: o diagnóstico de câncer de mama na perspectiva de pacientes e familiares

Abstract

In the face of a worldwide increase in the cases of breast cancer and the importance of the moment of communication of such news to patients and relatives, this study had, as its main purpose, the analysis of the description of the patient‟s and their families‟ reports, regarding their experience throughout the acknowledgement and transmission of the breast cancer diagnosis.The specific purposes were: to describe how patients and relatives call the disease when they receive and transmit the diagnosis, identify which family member the patients had more difficulty to transmit the diagnosis and investigate if patients and relatives shared a common feeling between themselves, regarding the disease. Twelve women with breast cancer and their respective families participated in the research, therefore creating two groups.The data collection was divided into two models of semi-structured interviews, one for each group. The analysis of the interviews followed the thematic content analysis technique. From the result of the patients‟ interviews, five thematic groups and fourteen themes emerged: 1) The beginning of the disease: Discovering any breast alterations and Looking for the diagnosis. 2) Receiving the breast cancer‟s diagnosis: Description of the moment, Medical words, The doctor: the individual responsible for breaking the bad news and The reactions before the news. 3) Transmission of the breast cancer‟s diagnosis: The way of the news, Language used, Families‟ reactions and Difficulties to tell; 4) Repercussions for being a woman with breast cancer: Feelings stored X shared, Changes in the families‟ behavior and Information pursuit. 5) Considerations concerning cancer: cancer and beyond. From the result of the relatives‟ interviews, four thematic groups and twelve themes emerged: 1) An account on the arrival of breast cancer in the family: The contact with the first symptoms of the disease and The way of the diagnosis; 2) The existence of the breast cancer‟s diagnosis: Receiving the diagnosis, Reactions and feelings, The names of the disease, Doubts and questions and Understanding cancer 3) Sharing the diagnosis: The different ways to communicate the diagnosis of cancer, Families‟ reactions and 4) Conversations about cancer: Sharing feelings, Hiding feelings and Dialogues about cancer. Most of the participants were satisfied by the way they knew the diagnosis. The word cancer‟ was not always used. The communication of the diagnosis considered information on different treatments and the possibility of a cure. The participants that acknowledged a possibility of an existing diagnosis of cancer showed a less significant impact on receiving the news. The patients had more difficulty to communicate the diagnosis to the people whom they thought would suffer more with the news. The patients that chose to share their feelings about the disease did so with closer persons. The same thing occurred with family members, who sought other people instead of the actual patients, to do so in order to spare them. Both groups reported that they hid some of their feelings in order to prevent any more sorrow.Studies with doctors are suggested, and patients with miss comprehension and in situations of relapse and metastasis.