Neurologists’ Real-life Experience When Breaking bad News, Dealing With Patients’ Reactions and Complexity of the Therapeutic Alliance With Multiple Sclerosis Patients


  • W. Houllé
  • B. Plazonnet
  • C. Tarquinio
  • M.L. Costantini


Background : This study is focused on neurologists’ real-life experience of breaking bad news in multiple sclerosis, their perception of their patients’ relationships and their perception of patients’ emotional, cognitive and behavioral reactions during this announcement in order to improving communication with multiple sclerosis patients. Methods: population : 15 neurologists ; data collection : semi-directive interviews ; data analysis : IPA and clinical analysis (qualitative approach). Findings: Themes with IPA : neurologist’s real-life experience of breaking bad news ; communications aspects and content of the diagnosis announcement ; complexity of the doctor-patient relationship in multiple sclerosis ; medical training and specificities of their profession… /Clinical analysis approaches: micro-traumatic impact on the doctor when he breaks bad news ; defence mechanisms mobilized ; empathy ; doctor’s anguish… Discussion : Psychic elements that we analysed, management of nonverbal communication and neurologist’s analysis of the patient’s reactions have an influence on the quality of the doctor-patient relationship, on the treatment adhesion and on the patient’s well-being.






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