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  Breaking bad news: professionals’ experiences of delivering diagnoses of motor neurodegenerative conditions

   Division of Health Research

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  Prof J Simpson, Dr I Fletcher, Dr F Eccles  No more applications being accepted  Competition Funded PhD Project (European/UK Students Only)

About the Project

Breaking bad news is not easy – either for the person receiving it or the person giving it. Moreover, giving a diagnosis of a neurodegenerative condition is a very challenging aspect of being a medical professional and yet it is so important that it is done appropriately. Indeed, it is generally agreed that the process of giving such a diagnosis – which can sometimes take just minutes - has the potential to have long term ramifications for how the individuals receiving it understand and manage the condition (Bunn et al., 2012).

Studies to date have indicated that in general patients feel that that giving a diagnosis is not done well (e.g., Fallowfield & Jenkins 2005). However, while the delivery of a serious physical diagnosis has received some attention from the patient perspective, less research has been conducted from that of the delivering physician. We have some general understanding of this process- giving a diagnosis has the potential to be stressful and difficult, especially when the diagnosis will have significant long term consequences. Doctors also frequently report a lack of training and anxiety around this aspect of their practice and it seems that a number of pressures (e.g., time) prevent their delivery of a more optimal consultation involving the delivery of a diagnosis. However, most of these studies regarding the delivery of serious physical diagnoses have been carried out within cancer services. While data collected in this area are useful, they are also relatively specific – given that many cancers are curable and consultations that contain the diagnosis are often also directed at treatment options. However, many physical conditions are not curable and many have limited options regarding treatment. Specifically, despite motor neurodegenerative conditions being relatively common, little research has currently addressed the perspectives of health care staff in the delivery of these diagnoses.

The focus of this PhD will be a mixed methods investigation of physicians’ experience of the delivery of diagnoses often given in movement disorder clinics – i.e. Parkinson’s disease, motor neuron disease and multiple sclerosis. Although the candidate will be able to contribute to the design process, it is likely that we will use quantitative data to assess current practice within the UK and internationally. It is also likely that in depth qualitative studies will be carried out to explore individuals’ experiences of the delivery of a diagnosis.

We are looking for a student who is interested in this area and in developing the research skills needed to be able to conduct excellent studies. You will be supported by three supervisors who have expertise in all the areas necessary to help make this an excellent thesis: Jane Simpson is an expert in psychological aspects of neurodegenerative diseases and mixed methods; Fiona Eccles is an experienced clinical psychologist with experience of working in neurology services; and Ian Fletcher conducts research on clinician-patient communication. Collectively we have excellent links with patient groups and other health networks. You would also conduct this research in a supportive environment and within a department with a large emphasis on ageing research and researching the doctor/patient interface. Collectively the supervisors have helped over 100 doctoral students successfully complete a doctoral thesis.

Applications are welcome from candidates with a good first degree in a relevant discipline (e.g., psychology, social science, medicine) and a demonstrable commitment to this project. To apply for this project you should complete an application for PhD Health Research October 2017 through our online application system. Closing date midnight 3rd April 2017. Informal enquires about the project should be made directly to Dr Jane Simpson.

Funding Notes

Awards are available for UK or EU students only for a maximum of three years full-time study. Awards will cover University Fees and Doctoral Stipend (2017-2018: £14,553).

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