Breaking bad news in medical practice

Bad news consists of messages concerning the actual state of a health problem. They evoke emotions on the side of the recipient and have an impact on his everyday life. To convey the message the physician makes use of his knowledge of the basic structure of an interview and of his skills of building a relationship. He describes the actual situation in comprehensible language. The patient and relatives need time to process what they have heard. Interviews with children have to take into account the stage of development and be responsive to several persons at one time. In video-based trainings participants become aware of what they cause by which means in an interview. The interviewing skills of all performers of the role of physician as evaluated by observers from outside are much better than perceived by themselves. As a rule emotions are expressed via the topics "cannot believe","whose guilt is it?" and "how to proceed in the future?" A relationship in which the physician is supportive raises hope and provides a perspective for the future.