Iranian Society of Gynecology Oncology

Document Type : Letter to the Editor


1 Department of Nursing, Faculty of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, IR Iran

2 Medical Department, Sabzevar University of Medical Sciences, Sabzevar, Iran


This letter comes to you in the hope of stressing the need to understand age differences and relevant requirements in delivering bad news to end-stage children. Among variables affecting the way healthcare providers communicate bad news, the age of the recipient is a critical factor requiring caregivers’ meticulous tactfulness. For practical purposes, various strategies are already suggested in communicating unexpectedly bad news to patients abruptly taken to face their end of life (1). However, patients of different ages may require different strategies. For some healthcare providers and physicians, breaking bad news to an elderly end-stage client may be taken for granted because public mindset is wired to assent to end-of-life deaths. While this tendency appears controversial by itself, communicating bad news to younger patients with life-threatening irremediable diseases appears more perplexing which should be given due attention in practice and special priority in training.
Young frivolous patients hope for life rather than death because children conceive of disease as a temporary stage of abnormal functioning of body systems; never do they expect dying if they become ill. The concept gradually transforms; for instance, school-age children may tend to blame themselves by attributing illness to their own actions but as they grow up, illness becomes increasingly attributed to external causes. Therefore, such conceptualizations should guide healthcare providers’ behavior toward their patients.


Main Subjects

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