P15.06.B BREAKING BAD NEWS IN NEURO-ONCOLOGY: A QUALITATIVE STUDY INTO THE EXPERIENCES AND NEEDS OF PATIENTS WITH GLIOMAS AND THEIR RELATIVES

Abstract BACKGROUND Healthcare professionals working with patients with gliomas face the challenge of navigating difficult conversations. After surgery the neurosurgeon discusses the diagnosis with the patient and their relatives. Tailored communication in this bad news conversation is essential, especially given the frequent cognitive impairments in this population. However, the specific needs of patients and relatives remain insufficiently understood and existing guidelines for breaking bad news have not been validated for this group. We aimed to explore the experiences and needs of patients and their relatives during bad news conversations, examine current practices, and assess how well current communication practices align with these needs. MATERIAL AND METHODS We conducted a single-center qualitative case study in the Netherlands. First, five bad news conversations were recorded and observed using a literature-based observation guide to assess the current situation and evaluate adherence to existing guidelines. Next, we conducted five additional dyadic interviews with patients and relatives. Descriptive statistics were applied on outcomes of the observations. Thematic analysis was used to analyse the interviews. RESULTS While the conversations each followed a certain structure, they varied in approach and did not fully adhere to existing general guidelines. Interview analysis revealed four main themes: communication about the diagnosis, social dynamics and support, information processing, and expectations and reactions. Participants valued direct, honest communication with room for questions. Although the diagnosis was often anticipated hope remained central. An empathic personal approach was appreciated, though extensive emotional support from the neurosurgeon was not expected. Patients were emotionally reserved while relatives responded more visibly. After the conversation many expressed a desire for written summaries. Communication largely aligned with participants’ needs. CONCLUSION This study provides insights into the experiences and needs of patients with gliomas and their relatives during bad news conversations. Clear, empathic communication with room for questions was valued with a focus on transparency and hope. Communication practices in this center met the needs of patients and relatives, although they did not fully adhere to existing general guidelines. This suggests the potential value of developing tailored guidelines for this specific population. Future research should explore how cognitive functioning affects emotional processing during bad news conversations and the role of emotional support in refining communication strategies for glioma care.