Abstract :
Background: “Bad News” is equated with terminal diagnoses in healthcare. However, in cardiopulmonary physiotherapy, patients may interpret Bad News as information about irreversible functional limitations, oxygen dependency, or life-disrupting contexts rarely examined in the literature.Objective: To explore patient and physiotherapist perceptions of Bad News and understand expectations around its communication in cardiovascular and respiratory physiotherapy.Materials and Methods: A mixed-methods study was conducted in the physiotherapy outpatient department (OPD) of a tertiary hospital. A validated, structured questionnaire was administered to 150 adult patients (aged 20–70 years) with cardiac or respiratory conditions to assess perceptions, emotional responses, and communication preferences. Qualitative data were collected through two patient focus group discussions (FGDs), one FGD with experienced physiotherapists, and expert interviews with communication experts. Results: Survey responses demonstrated that 28% of patients associated “Bad News” with fear, 20.7% with stress, and 15.3% with existential reactions, such as “why me?”; 93% of participants preferred to receive Bad News from their treating doctor, in a private setting, with honesty and empathy. Qualitative findings revealed that Bad News was commonly linked to the loss of function, work roles, or autonomy rather than diagnosis. Physiotherapists expressed emotional burden in delivering such news and reported minimal formal training. Expert interviews emphasized contextual sensitivity, gradual disclosure, and the ethical imperative for structured communication education in physiotherapy.Conclusion: Bad News in cardiopulmonary physiotherapy encompasses more than diagnosis, involving loss of function, independence, and identity. Patients desired honest yet empathetic communication tailored to their context. There is a critical need to embed communication ethics training in physiotherapy education for recognizing the role of physiotherapists in breaking and contextualizing Bad News.
Keyword :
Bad News, Communication, Truth disclosure, Cardiac rehabilitation, Pulmonary rehabilitation, Ethics, Patient satisfaction, Qualitative research