Nurses’ perspectives on breaking bad news: the impact of resilience and self-empowerment in the era of the COVID-19 pandemic

Introduction: The COVID-19 pandemic has exposed health professionals to conditions of increased stress, traumatic stress and depression, thereby reducing their resilience in treating patients with serious health problems, as well as in communication. In this environment, it is important to investigate the factors that influence nurses' attitudes towards informing patients who have serious or life-threatening illnesses.

Aim: The aim of this study is to investigate the factors that influence nurses' attitudes towards informing patients who have serious or life-threatening illnesses.

Material and Methods: One hundred thirty four nurses and assistant nurses of KAT hospital participated in the present synchronous research. A questionnaire was used for the data collection that included demographic / social characteristics, and 4 tools (scale of psychological empowerment-PEI, scale of physicians 'attitude towards informing patients, scale of physicians' attitude towards informing cancer patients, CD-RISC-10) . Data analysis was performed using SPSS 21.

Results: Relatively high level of resilience (average 27.9, mean 6.38) and psychological empowerment (average 46,029, mean 7.41) was found. Regarding the three sub-scales of the WHO model: the sub-scale of truth disclosure, had a relatively high level (average 5.94, S.D.1.25), the sub-scale of concealment of truth had medium level (average 5.02, S.D.1,36), and the sub-scale personalized information with high level (average 6.86, S.D.1,009). Regarding the correlations, statistical significance was found (p:, 025) between the sub-scale Hidden Truth and Communication (<0.05), between the sub-scale Personalized Information and Communication (<0.01). In addition, statistical significance was found between Durability and Strengthening (<0.01).

Conclusions: According to the objectives of the present study, the results showed the following: (a) nurses have a relatively high level of resilience, psychological empowerment and attitude in communication (for serious, chronic diseases), which highlights the special requirements of the nursing profession (b) personalized information is influenced by the attitude of nurses in communication (for serious & chronic diseases), and also, the work department of the nurse affects the disclosure and concealment of the truth in communication with the patient, and the position The nurse's responsibility affects the concealment of the truth when communicating with the patient about serious illnesses. However, new research on the subject of the present study needs to be conducted. Thus, it is proposed in the future to conduct a similar primary research with a larger sample and change the WHO measurement tool (or its extension), since it cannot work reliably due to its small size.

Keywords:  communication, health professional, nurse, resilience, empowerment, bad news