Correlations Between the Communication of Bad News and Psychological Capital Among Nursing Professionals
The global rise in cancer and other life-threatening diseases has made delivering bad news is a challenging yet essential task for nurses, yet little is known about its relationship with psychological capital (PsyCap). This study aimed to examine the correlations between bad news communicating ability and psychological capital (and its dimensions: self-efficacy, hope, resilience, optimism) among clinical nurses. A cross-sectional survey was conducted among 281 nurses using convenience sampling. Data were collected using a demographic questionnaire, the Chinese version of the Communicating Bad News (CBN) scale, and the revised Psychological Capital Questionnaire (PCQ). Descriptive statistics and Pearson correlation were used for analysis. The mean CBN score was 2.84±0.80 (moderately low), and the mean PCQ score was 4.54±0.87 (moderately high). CBN total score was positively correlated with PCQ total score (r = 0.310, P < 0.01). At the dimensional level, the strongest correlation was between the resilience of PCQ and the strategy dimension of CBN (r = 0.330). All correlations were low to moderate but statistically significant (r range: 0.204-0.330, all P < 0.01). Nurses' ability to communicate bad news is positively and significantly correlated with their psychological capital, especially resilience. Enhancing PsyCap may improve bad news communication skills.
[1] Baile, W. F., Buckman, R., Lenzi, R., Glober, G., Beale, E. A., & Kudelka, A. P. (2000). SPIKES-a six-step protocol for delivering bad news: Application to the patient with cancer. The Oncologist, 5(4), 302-311. https://doi.org/10.1634/theoncologist.5-4-302
[2] Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall.
[3] Davis, S., & Nunn, M. (2023). Palliative communication in the pediatric intensive care unit. Critical Care Nursing Clinics of North America, 35(3), 287-294. https://doi.org/10.1016/j.cnc.2023.04.003
[4] González-Cabrera, M., Ortega-Martínez, A. R., Martínez-Galiano, J. M., Hernández-Martínez, A., Parra-Anguita, L., & Frías-Osuna, A. (2020). Design and validation of a questionnaire on Communicating Bad News in nursing: A pilot study. International Journal of Environmental Research and Public Health, 17(2), 457. https://doi.org/10.3390/ijerph17020457
[5] Han, B., Chen, X., Xu, F., Li, Q., Wang, S., & Gang, T. (2021). Correlation analysis between resilience and career development of nurses. Chinese Journal of Nursing, 56(2), 255-260.
[6] Harris, D., & Gilligan, T. (2022). Delivering bad news. Medical Clinics of North America, 106(4), 641-651. https://doi.org/10.1016/j.mcna.2022.02.004
[7] Haverfield, M. C., De Leon, G., Johnson, A., Jackson, V. L., Basu, G., & Dodge, J. (2024). Transforming the discharge conversation through support and structure: A scoping review. International Journal of Nursing Studies Advances, 6, 100203. https://doi.org/10.1016/j.ijnsa.2024.100203
[8] Hulley, S. B., Cummings, S. R., Browner, W. S., Grady, D. G., & Newman, T. B. (Eds.). (2013). Designing clinical research (4th ed.). Wolters Kluwer.
[9] Ji, J. & Chen, Z. (2020). Correlation between psychological capital and job burnout and coping styles of psychiatric nurses. Chinese Journal of Practical Nursing, 36(29), 2298-2302.
[10] Li, Y., Gao, Y., Liu, Y., Chen, H., Zhang, M., & Wang, N. (2022). Translation of Communicating Bad News scale and testing of its reliability and validity. Journal of Nursing Science, 37(20), 68-71.
[11] Li, Y., Dong, X., Wang, Z., Yang, Z., Zheng, X., Jiang, X., Liu, Y., & Wang, A. (2025). Chinese nurses' ability to communicate bad news: A latent profile analysis and influencing factors. BMC Nursing, 24(1), 795. https://doi.org/10.1186/s12912-025-03440-y
[12] Luo, H. & He, Z. (2010). Reliability and Validity of the Psychological Capital Questionnaire Applied Among Nurses. Chinese Journal of Behavioral Medicine and Brain Science, 19(9), 853-854. https://doi.org/10.3760/cma.j.issn.1674-6554.2010.09.028
[13] Luthans, F., Luthans, K. W., & Luthans, B. C. (2004). Positive psychological capital: Beyond human and social capital. Business Horizons, 47(1), 45-50. https://doi.org/10.1016/j.bushor.2003.11.007
[14] Luthans, F., Avey, J. B., & Patera, J. L. (2008). Experimental analysis of a web-based training intervention to develop positive psychological capital. Academy of Management Learning & Education, 7(2), 209-221. https://doi.org/10.5465/amle.2008.32712618
[15] Rayan, A., Hussni Al-Ghabeesh, S., & Qarallah, I. (2022). Critical care nurses' attitudes, roles, and barriers regarding breaking bad news. SAGE Open Nursing, 8, 23779608221089999. https://doi.org/10.1177/23779608 221089999
[16] Snyder, C. R. (2002). Hope theory: Rainbows in the mind. Psychological Inquiry, 13(4), 249-275. https://doi.org/10.1207/S15327965PLI1304_01
[17] Soosaipillai, G., Archer, S., Ashrafian, H., & Darzi, A. (2020). Breaking bad news training in the COVID-19 era and beyond. Journal of Medical Education and Curricular Development, 7, 2382120520938706. https://doi.org/10.1177/2382120520938706
[18] Wahyuni, S., Gautama, M. S. N., & Simamora, T. Y. (2023). A literature review of nurses challenges and barriers in assisting patients and families facing breaking bad news. Indian Journal of Palliative Care, 29(3), 243-249. https://doi.org/10.25259/IJPC_128_2023
[19] Wang, Y., Xu, G., Li, L., & Li, Y. (2016). The identifying and responding to the difficult circumstance in clinical nurse-patient communication. Journal of Nursing Administration, 16(10), 729-730+760.
[20] Zhang, R. & Zhao, Q. (2013). Content analysis of the reasons of non-disclosure of truthful information to cancer patients by their families. Chinese Journal of Practical Nursing, 29(29), 67-70.