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Most physicians experience difficulty when required to deliver bad news. Therefore, recommendations for facilitating breaking bad news were reviewed and a suitable model was described in this study. We performed a search with keywords “breaking bad news”, “strategy”, “protocol”, “guideline” and “model” as the primary descriptors, and limiting the sources to English language articles with abstracts and guidelines, published since 1961 to March 2013. Two trained authors independently reviewed titles, abstracts and full texts of articles after a pilot inter-rater reliability assessment. All articles dealing specifically with breaking bad news were examined; they were descriptive and analytical studies. Recommendations and best models for facilitating breaking bad news from these articles were explored; sorted into discrete categories, summarized and framed as the best model for breaking bad news. The latest models, tools, steps and recommendations (e.g., delivering the bad news at a suitable and calm environment, giving the news with empathy and …) were examined. Although many articles have discussed the topic of breaking bad news, those that occurred repeatedly throughout these articles were summarized. Finally, the reference steps as according to the most important models for breaking bad news were presented. It is suggested that for more effective investigations, studies regarding interactional approaches in patients–medical team relationships be conducted on breaking bad news interventions.

A Suitable Model for Breaking Bad News: Review of Recommendations