Exploring the perspectives of chronic patients on the communication of bad news

Background. The communication of bad news is a critical clinical challenge that profoundly affects patient well-being and the physician-patient relationship. In cultural contexts such as Iran, where family involvement is paramount, patient preferences for this process are not well understood, representing a significant gap in patient-centered care. Methods. This descriptive, cross-sectional study was conducted in 2023 at a tertiary hospital in Zahedan, Iran. We surveyed 120 chronic patients using a validated 30-item questionnaire to assess their perspectives on the communication of bad news. The convenience sample included patients aged 18 years and older. Data were analyzed using descriptive statistics. Results. The sample comprised 76 (63.3%) males and 44 (36.7%) females, with a mean age of 56.5 ± 10.6 years. A majority of patients (73.3%) believed they should be fully informed about adverse news, and all respondents (100%) agreed or were neutral about the essential role of a psychological counselor. However, 76.7% reported that receiving bad news from a physician led to negative perceptions of that physician. Consequently, only 26.7% agreed that a specialist physician is the most suitable person to deliver such news. Conclusion. Chronic patients in this Iranian cohort express a strong desire for full disclosure but also indicate that the communication process itself can damage the physician-patient relationship. The findings underscore a critical need for systemic changes that go beyond physician training, including the guaranteed provision of privacy, routine integration of psychological support, and a family-inclusive approach to mitigate negative emotional impact and foster trust.