The event of breaking bad news is a subject that no one present in the practical setting could choose to avoid. It is a subject that the practitioners comes in touch with during a daily basis. Traditionally the role as the breaker of bad news has been settled by the physician, but at the time being, disagreements occur in the clinical setting about who should break bad news to familys and patients. Aim: The aim of this study was to explore the nurses’ experiences of breaking bad news. What are the nurses’ role in the event of breaking bad news, and are there any barriers that can affect the way the bad news is given to the patients and family members? These were two questions of issue that were looked into. Method: The integrative review method based out of Whittemore and Knafl (2005) was used for this review. A systematic search resulted in twelve articles that were deemed fitting for the purpose of this study. Results: This integrative review resulted in five identified roles carried out by the nurse in the event of breaking bad news. Further on, nine factors were identified as being of significance in how the bad news were delivered by nurses and received by patients and the patient’s family members. Nurses expressed a desire and a wish for some kind of education or training in how to break bad news. Conclusion:  This article contributes with five roles experienced by nurses, along with nine different factors to have in mind when carrying out difficult news. The SPIKE model and Gibbs reflective model were discussed to have a great importance in the clinical setting.

Estudo quase experimental, com grupo de intervenção avaliado antes e após o procedimento, com o objetivo de capacitar os profissionais da saúde para as situações de comunicação de más notícias aos pacientes e aos seus familiares, por meio de um curso de difusão gratuito, com duração de cinco horas. Participaram 79 profissionais da saúde, entre enfermeiros, estudantes de enfermagem, biólogos, farmacêuticos, estudantes de medicina, psicólogos, assistentes sociais e terapeutas ocupacionais. Foram utilizados como instrumentos de pesquisas: 1) o questionário Breaking Bad News sobre o protocolo SPIKES, que possui 13 questões objetivas. Este questionário foi analisado pela distribuição da porcentagem de respostas para cada questão; 2) o questionário de avaliação do curso de más notícias composto por 43 questões objetivas. Para a análise das variáveis quantitativas foram utilizadas as médias e as medianas para resumir as informações, e os desvios-padrão, mínimo e máximo, para indicar a variabilidade dos dados, além da porcentagem. A comparação entre as pontuações dos participantes na primeira e na segunda avaliação de habilidades de comunicação foi realizada pelo teste estatístico de McNemar. O teste estatístico não paramétrico Mann-Whitney foi utilizado para comparar a relação entre a idade dos participantes e as respostas do questionário de avaliação do curso de más notícias. A comparação entre a idade e a pontuação total dos participantes na avaliação de conteúdo do curso foi feita pelo coeficiente de correlação de Spearman. Para todos os testes assumiu-se o nível de significância em 5%. A idade dos participantes variou entre 18 e 55 anos, sendo a maioria do sexo feminino (83,5%) e da área da enfermagem (53,2% profissionais e 24,1% estudantes). Ademais, 57% dos participantes nunca tiveram qualquer formação sobre transmissão de más notícias, porém mesmo após este curso, oito pessoas continuaram afirmando que não tiveram formação alguma. A autoavaliação da capacidade de informar uma má notícia no pré-teste foi considerada boa por 18,2%; 20,8% consideraram-se ruins e 6,5%, péssimos, enquanto que o pós-teste 42,8% consideraram-se bons, 11,7%, ruins e 2,6%, péssimos. O conforto do profissional neste momento variou de 21,8% para 7,7% no item absolutamente desconfortável, e de 6,4% para 14,1% no item confortável. Após o conhecimento sobre o protocolo SPIKES, 92,3% acreditam em sua aplicabilidade na prática clínica.Quanto à estratégia utilizada pelos entrevistados em sua prática clínica, o item mostrou que \"um plano ou estratégia consistente\" apresentou frequências de 21,9% no pré-teste e 51,56% no pós-teste. Os elementos do protocolo SPIKES apontados como de maiores facilidades entre os participantes no pré-teste foi o local da notícia e a verificação da compreensão de tudo o que foi dito, 30,6% e 28,6%, ao passo que no pós-teste o item mais escolhido foi a escolha do ambiente (53,06%). A relação entre idade e conhecimento do protocolo SPIKES teve apenas um item que apresentou significância. Concluiu-se, portanto, que o treinamento de habilidades de comunicação de más notícias atingiu seus objetivos melhorando o conhecimento e a aptidão dos profissionais da saúde. Evidenciou-se também que a educação em comunicação na área da saúde mantém-se falha, bem como é escassa a difusão de protocolos que abarquem esta difícil tarefa destinada aos profissionais da saúde. O pós-teste mostrar-se-ia mais eficaz caso fosse aplicado após o retorno dos profissionais aos seus pacientes e o uso das técnicas apreendidas. Sugerimos a adoção de educação permanente aos atuantes na área da saúde / A quasi-experimental study with an intervention group evaluated before and after the procedure, in order to enable health professionals to communicate bad news to patients and their families through a free course of five hours duration. We evaluated 79 health professionals, including nurses, nursing students, biologists, pharmacists, medical students, psychologists, social workers and occupational therapists. The following research tools were used: 1) the Breaking Bad News questionnaire about the SPIKES protocol, which has 13 objective questions. This questionnaire was analyzed by the distribution of the percentage of answers for each question; 2) the evaluation questionnaire of the course of bad news composed by 43 objective questions. For the quantitative analysis we used the means and the medians to summarize the information, and the standard deviations, minimum and maximum to indicate the variability of the data, besides the percentage. The comparison between the scores of participants in the first and second evaluation of communication skills was performed by the McNemar statistical test. The Mann-Whitney non-parametric statistical test was used to compare the relationship between the age of the participants and the responses of the evaluation questionnaire of the course of bad news. The comparison between the age and the total score of the participants in the evaluation of course content was made by the Spearman correlation coefficient. For all tests, the level of significance was set at 5%. The participants\' ages ranged from 18 to 55 years old, with most females (83.5%) and nursing (53.2% professionals and 24.1% students). In addition, 57% of the participants never had any training on the transmission of bad news, but even after this course, eight people continued to claim that they had no training. The self-reported ability to report bad news in the pre-test was considered good by 18.2%; 20.8% were considered bad and 6.5% were poor, while the post-test 42.8% were considered good, 11.7%, bad and 2.6% Lousy. The comfort of the professional at the time ranged from 21.8% to 7.7% on the uncomfortable item and from 6.4% to 14.1% on the comfortable item. After knowing about the SPIKES protocol, 92.3% believe in its applicability in clinical practice. Regarding the strategy used by the interviewees in their clinical practice, the item showed that \"a consistent plan or strategy\" presented frequencies of 21.9% in the pre-test and 51.56% in the post-test. The elements of the SPIKES protocol identified as greatest facilities among participants in the pre-test were the news site and the verification of the understanding of all that was said 30.6% and 28.6%, while in the post-test the most chosen item was the choice of the environment (53.06%). The relationship between age and knowledge of the SPIKES protocol had only one item that presented significance. It was concluded, therefore, that communication education in the health area remains flawed, as well as the dissemination of protocols that cover this difficult task for health professionals. The post-test would be more effective if it were applied after the return of the professionals to their patients and the use of the seized techniques. We suggest the adoption of permanent education to those in the health area

本研究係探討「上市公司季盈餘宣告」與「投信持股比例」之關係，希望瞭解季盈餘資訊對基金經理人投資決策之影響方向與程度。樣本涵蓋期間為民國八十四年第四季至八十六年第一季，以國內全體基金及其投資標的為研究對象，採用 t 檢定（單尾、雙尾）及簡單迴歸分析進行研究，實證結果如下： 一、關於「季盈餘成長率」與「持股比例變動百分比」之相關性： 就整體樣本而言，此二項變數間的關係並不顯著，但就產業別而言，「金融類股」與「其他類股」則出現顯著的結果，顯著水準分別是 1%與 5%。 二、關於「好消息」與「持股比例變動百分比」之相關性： 「季盈餘成長率」與「持股比例變動百分比」均達到 1% 的顯著水準，且後者的 t 值為證數，顯示好消息確實會引起持股比例顯著增加。 但就變動幅度的相關性加以分析，整體樣本的迴歸分析結果並不顯著，在產業類別方面，僅有「其他類股」出現顯著的狀況，達到 1%顯著水準。 三、關於「壞消息」與「持股比例變動百分比」之相關性： 「季盈餘成長率」與「持股比例變動百分比」均達到 1%的顯著水準，但後者的 t 值為負數，表示壞消息的出現反而造成持股比例顯著增加。 若就變動幅度的相關性加以分析，全體樣本迴歸分析結果達到 10%的顯著水準，至於在產業別方面，計有塑膠、營建、金融等三種產業出現顯著的結果，顯著水準分別是 10%、1%、1%。 四、關於「好消息的幅度」與「持股比例增加幅度」的分組檢定： 四組「好消息的幅度」均達到 1%的顯著水準，而四組「持股比例增加幅度」亦均達到 5%的顯著水準，顯示只要出現好消息，不論幅度大小，均會引起持股比例顯著增加。 但是迴歸分析方面，四組皆未達到顯著水準，顯示「持股比例增加的幅度」與「好消息的幅度」並不具有顯著的相關性。 五、關於「壞消息的幅度」與「持股比例減少幅度」的分組檢定： 四組「壞消息的幅度」均達到 1%的顯著水準，而四組「持股比例減少幅度」亦均達到 5%的顯著水準，顯示只要出現壞消息，不論幅度大小，均會引起持股比例顯著增加。原因可能亦為投信基金進場承接的結果。 至於在迴歸分析方面，四組皆未達到顯著水準，顯示「持股比例增加的幅度」與「壞消息的幅度」並不具有顯著的相關性，亦即只要出現壞消息投信基金就可能進場承接，但承接時買進的幅度與壞消息的幅度並未沒有顯著的相關性。 六、關於「本季盈餘成長率大於前一季」與「持股比例變動百分比」之相關性： 不論是全體樣本或細分的三組樣本（正正、負正、負負）均出現顯著的結果，除了「負正組」的顯著水準為 5%外，全體樣本與其餘二組（正正、負負）的顯著水準均為 1%。顯示投信業者相當重視上市公司盈餘改善的訊息，只要本季盈餘成長率大於前一季，不論前後二季盈餘成長率究竟是正號或負號，投信基金均會顯著增加持股比例。 七、關於「本季盈餘成長率小於前一季」與「持股比例變動百分比」之相關性： 不論是全體樣本或細分的三組樣本（正正、正負、負負）均出現顯著的結果，全體樣本與「負負組」的顯著水準為 1%，「正正組」與「正負組」的顯著水準為 5%。但四種情況的 t 值均為正數，與假說之預期正好相反，表示本季盈餘成長率小於前一季時，確實會引起投信基金進場承接。 / The purpose of this study is to investigate the impacts of quarterly report announcement on portfolio revision of mutual funds in the Taiwan stock market. Based on economics of information, mutual fund can be considered as a professional investor in the market such that management of mutual fund wold apply his (her) professional knowledge to forecast the realized number of earnings this period. Therefore, this study hypothesizes that mutual funds would response to the announcement of quarterly earnings earlier than other investors such that the porfolio of mutual fund would accord the announcement to make proper revision. The findings of this study can be summarized as follows. ● Except for financial servics and others industry groups, the relationship between the announcement of quarterly earnings and porfolio revisions of mutual funds is not significant. ● The positive growth of quarterly earnings will cause the significant porfolio revisions of mutual funds; but the relationship between their magnitude is not significant. ● The negative growth of quarterly earnings will cause the reverse significant porfolio revisions of mutual funds. This results implies mutual fund may be an instrument for maintaining price; or mutual fund may consider the bad news of this period being the worst condition of the firm. ● It is robust to conclude whatever itis a good news or not, mutual fund will increase its holdings. In particular, these results hold when the next quarter has the same sign of earnings growth.

本論文的目的，在探討我國自願性財務預測公告與證券信用交易之間的關係。信用交易的增減代表使用信用交易的投資者對某特定資訊的瞭解與使用，因此實證檢視財務預測的修正行為與信用交易增減的關係，可以敏銳地瞭解，是種特定投資者在哪個時點對財務預測修正進行理性預期，並予使用且做了較實際的交易行為。因此，本研究的測試可以瞭解使用信用交易的投資者如何使用財務預測等相關資訊。據此，本研究的結果有助於了解使用信用交易的投資者如何運用自願性財務預測資訊來做投資決策。 　　研究期問是以民國八十四年至八十六年的資料為分析的對象，研究的結果顯示： 　　一、在季報（半年報、年報）公告前公佈的財務預測，好消息會引起融資顯著增加，融券增加幅度雖不如融資大，但結果亦為顯著；壞消息會使融資及融券同樣顯著增加，但融資增加幅度亦較融券顯著。 　　二、在季報（半年報、年報）公告後公佈的財務預測，好消息會引起融資顯著增加，融券增加幅度雖不如融黃大，但結果亦為顯著；壞消息會使融資及融券同樣顯著增加，但融資增加幅度亦較融券顯著。 / This study aims to examine the relationship between an announcement of voluntary forecasts and credit transactions, including margin and short transactions. In general, an announcement of good news would attract investor to employ margin for a long position, and vice versa. Since only noisy trader can employ credit transaction in Taiwan, this study hypothesizes that investors would follow the announcement for making rational expectation. The results of this study could help understand how noisy traders use a financial forecast. This study selects the samples occurred between 1995 and 1997 to test the established hypotheses. 　　The empirical results can be summarized as follows. 　　●If the announcement of voluntary forecast occurred prior to the release of quarterly, semiannual, and annual reports, both good and bad news simultaneously cause an increase of margin and short transactions during this period. However, the magnitude of margin transactions is significantly higher than that of short transactions. 　　●If the announcement of voluntary forecast occurred subsequent to the release of quarterly, semiannual, and annual reports, both good and bad news simultaneously cause an increase of margin and short transactions during this period; however, the magnitude of margin transaction is significantly higher than that of short transaction. 　　Since noisy traders are essentially information followers, their judgement significantly relates to functional efficiency of informational intermediaries. These empirical results imply the function of informational intermediaries requires further improvement.

An individual’s bad news reporting behavior has been studied from a number of perspectives and has resulted in a variety of research streams including the MUM effect (or reluctance to transmit bad news), whistle-blowing, and organizational silence. While many scholars in different areas have studied reporting behavior, it has not been widely discussed in the information systems literature. This dissertation research addresses an individual’s bad news reporting behavior (and its antecedents) in the troubled IT project context. Many social phenomena are multi-causal (Hollander 1971). The silence phenomenon involved in an individual’s bad news reporting behavior is multi-causal too. While prior research has identified many antecedents to the bad news reporting behavior, it has not provided any systematic approach for categorizing them. In this dissertation, the antecedents are categorized into three different levels: personal factors (i.e., individual-level factors), situational factors (i.e., project-level factors), and organizational factors. This research empirically investigates how the antecedents at different levels affect (i.e., encourage or discourage) an individual’s decision to report or not report bad news in the IT project context. The dissertation follows a multi-paper model, and includes three independent, empirical studies, each with its own research model focusing on personal, situational, and organizational factors.

Background: Health care is a strange place for the patient. To make this enviroment as good as possible, would the patient be well informed. The patient has right to know if it is a bad mews and often he/she needs caring after the information. Nurse´s basic responsibility is caring, for her/him it´s important to prevent the shock for the patient that can appear.  Aim: Describe the nursing staff responses to the patient, using the patient´s perspective in relation to bad news.  Method: A litterture review has been made with nine articles. Current research materials that meet the study´s purpose has been applied in databases and analyzed. Four themes and nine subthemes was emerged.  Results: Nurse should allow patient to talk, when bad news had been given. Conversation is important for the patient, because they want information to be able to participate in care. Good communication skills are important for the nurse in connection with bad news. Patient wants information in an honest, peaceful and transparent manner. Time is often in short supply in this conversation. To have the family in care is a good support for the patient, but not all patients want the family to participate.  Conclusion: Patients desire individually aids at handover of bad news. It gives them a safety. The most common mould of aids according to patients where that the nurse shows that she/he has time for them.

Submitted by Nathalia de Lima Silva null (nathalia.limaenf@ig.com.br) on 2017-12-09T22:09:47Z No. of bitstreams: 1 Estudo sobre a presença de espaços propícios à comunicação de más notícias em hospitais escola do estado de São Paulo.pdf: 4398926 bytes, checksum: cf2b9c8749e4ed2d3ab886f6ee815b27 (MD5) / Submitted by Nathalia de Lima Silva null (nathalia.limaenf@ig.com.br) on 2017-12-11T18:47:11Z No. of bitstreams: 1 Estudo sobre a presença de espaços propícios à comunicação de más notícias em hospitais escola do estado de São Paulo.pdf: 4398926 bytes, checksum: cf2b9c8749e4ed2d3ab886f6ee815b27 (MD5) / Approved for entry into archive by ROSANGELA APARECIDA LOBO null (rosangelalobo@btu.unesp.br) on 2017-12-12T12:05:09Z (GMT) No. of bitstreams: 1 silva_nl_me_bot.pdf: 4398926 bytes, checksum: cf2b9c8749e4ed2d3ab886f6ee815b27 (MD5) / Made available in DSpace on 2017-12-12T12:05:09Z (GMT). No. of bitstreams: 1 silva_nl_me_bot.pdf: 4398926 bytes, checksum: cf2b9c8749e4ed2d3ab886f6ee815b27 (MD5) Previous issue date: 2017-11-10 / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Pró-Reitoria de Pesquisa (PROPe UNESP) / Introdução: A comunicação de más notícias envolve situações como a comunicação sobre diagnósticos que ameaçam a vida, a deterioração clínica ou mesmo a morte de um paciente. A forma como esse tipo de informação é transmitido pode ter um impacto profundo na compreensão dos pacientes e de seus familiares sobre a doença, sobre sua capacidade de lidar com a nova situação e pode amplificar ou diminuir o seu sofrimento. Várias pesquisas relativas à comunicação de más notícias nos cuidados de saúde enfatizam a importância de um ambiente físico apropriado para a condução desse processo. Todavia não foram encontrados estudos que tenham avaliado os espaços físicos onde essa comunicação se dá. Portanto, propôs-se o presente projeto de pesquisa com o objetivo de avaliar a presença e as características de ambientes apropriados para a comunicação de más notícias em hospitais escola do estado de São Paulo. Métodos: Todos os hospitais de ensino elegíveis foram convidados a participar do projeto. Uma vez que os hospitais aceitassem participar, era agendada uma visita guiada aos seguintes setores de cada hospital: Unidades de Terapia Intensiva (UTI), antessalas do centro cirúrgico, enfermarias de clínica médica, cirurgia, oncologia, neurologia, geriatria, pediatria e cuidados paliativos. Resultados: Foram convidados 30 hospitais para o estudo, dos quais 15 concordaram em participar. De 156 setores hospitalares visitados havia apenas 15 (9,6%) com salas para comunicação privada entre profissionais de saúde e pacientes/familiares. Em 98 (62,8%) dos setores visitados não havia sequer salas improvisadas que poderiam ser utilizadas para tais comunicações. Conclusão: Na maioria dos setores dos hospitais de ensino visitados há carência de espaços apropriados para comunicação de más notícias ou conversas privadas sobre questões sensíveis com pacientes ou familiares. A ausência de tais ambientes impõe barreiras à comunicação efetiva e empática entre profissionais de saúde e pacientes/familiares. O ambiente físico dos hospitais de ensino transmite mensagens importantes e silenciosas aos alunos, profissionais de saúde e pacientes sobre o que é valorizado ou não dentro dessas instituições. Refletir de forma crítica sobre a forma como os hospitais organizam seu espaço pode inspirar a reestruturação desses ambientes de acordo com os valores e metas pretendidas dessas instituições. / Introduction: The breaking of bad news involves situations such as the communication about life-threatening diagnoses, the clinical deterioration or even the demise of a patient. The way in which those types of information are conveyed may have profound impact in the under-standing of patients and families about the illness, in their ability to cope with the new situa-tion, and may amplify or lessen their suffering. Several guidelines concerning the communi-cation of bad news in healthcare emphasize the importance of an appropriate physical envi-ronment for the conduction of that process. However there are no studies about the physical environments where such communication processes take place. Therefore we proposed the present research to assess the presence and the characteristics of appropriate places for the communication of bad news within teaching hospitals in the state of Sao Paulo. Methods: All eligible teaching hospitals of state of São Paulo were invited to participate in the project. Once one of those hospitals accepted to participate, we scheduled a guided visit to the following sectors of each hospital: Intensive Care Units (ICU), access points to operating suites, Internal Medicine, General Surgery, Oncology, Neurology, Geriatrics, Pediatrics, and Palliative Care wards. Results: Thirty teaching hospitals were invited for the study and 15 agreed to participate. Out of 156 hospital sectors visited there were only 15 (9.6%) rooms for private communications between professionals and patients/families. In 98 (62.8%) of the visited sectors there were not even improvised rooms available for such communications. Conclusion: Our results show that within most sectors of the teaching hospitals that we visited there is a lack of appropriate spaces for the breaking of bad news and other conversations about sensitive issues with patients or their family members. The absence of such rooms imposes barriers to effective and empathetic communication between healthcare professionals and patients and/or their families. The physical environment of teaching hospitals conveys im-portant soundless messages to students, healthcare professionals and patients about what is valued or not within those institutions. Reflecting critically about the way hospitals organize their space may inspire the redesign of those environments according to the intended values and goals of those institutions.

abstract: Employees are directly involved in work tasks and processes which are necessary to accomplish unit or organizational goals, and accordingly, they may become aware of key mistakes, slips, and failures that are unbeknownst to the leader or supervisor responsible for the work unit or organization. Given that errors or deviations in work tasks or processes can have far-reaching effects within the organization, it may be essential for employees to share bad news with their leader or supervisor so that steps can be taken to address the issue or ameliorate negative consequences. However, although employees' sharing of bad news may be important to the organization and should be encouraged, supervisors may respond to the messenger in ways that discourage the behavior. Unfortunately, we lack an explanation of why and under what conditions supervisors respond positively or negatively to employees who share bad news. Thus, the purpose of this dissertation is to address this gap in our understanding. I draw from social exchange theory and the transactional theory of stress to develop a conceptual model of sharing bad news. I suggest that sharing bad news can be cast as a transaction between employees and supervisors that is mediated by supervisors’ appraisals of employees’ sharing the message. The quality of the relationship between an employee and supervisor, or leader-member exchange (LMX), is strengthened when supervisors appraise the sharing of bad news as challenging, or potentially rewarding; however, LMX is weakened when supervisors appraise the sharing of bad news as hindering, or potential harmful. In turn, LMX influences supervisor responses to the sharing of bad news in the form of evaluations of the employee’s effectiveness. In addition to these main effects, I also consider how aspects of the message delivery, such as the timeliness with which messages are conveyed and extent to which employees incorporate solutions when they share bad news, can influence supervisor appraisals of sharing bad news. Finally, I suggest that the extent to which the messenger is responsible for the bad news moderates the relationships between appraisals of sharing bad news and LMX. I test this model in three studies. / Dissertation/Thesis / Doctoral Dissertation Business Administration 2017

Resumo: Métodos de comunicação tem se mostrado úteispara minimizar o estresse do profissional de saúde e facilitar o processo de informar más notícias em saúde para os pacientes. Este trabalho tem por objetivo descrever um protocolo de comunicação (protocolo PACIENTE) e avaliar sua aceitação. Foram realizados treinamentos sobre comunicação de más notícias, onde o método PACIENTE foi apresentado. Após obtenção consentimento livre e esclarecido, distribui-se um questionário com 12 perguntas de múltipla escolha sobre a experiência pregressa em comunicação e sobre as impressões acerca de protocolo apresentado. Houve 200 participantes, sendo 100 médicos e 100 enfermeiros. Os temas considerados mais dificeis no processo de comunicação foram: falar sobre a morte (39,5%)... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Methods of communicationg bad news has been proven effective to minimize heath professionals' stress and easier the bad news disclosure to the patients. The objective of this research is to describe a communication protocol (PACIENTE) and evaluate its acceptance. The protocol PACIENTE was presented during trainings about bad news disclosure. After informed consent, a questionnaire of multiple choice responses was given to the participants concerning previous experiences in communication and about their impressions on the presented protocol. There were 200 participants, 100 doctors and 100 nurses. The most difficult points on the communicating bad news were: discuss death (39,5%), and... (Complete abstract click electronic access below) / Orientador: Guilherme Antonio Moreira de Barros / Coorientador: Lino Lemonica / Banca: Norma Sueli Pinheiro Pinheiro Módolo / Banca: Irimar de Paula Posso / Banca: Reinaldo Ayer de Oliveira / Banca: Maria Júlia Paes da Silva / Doutor

Estudo quase experimental, com grupo de intervenção avaliado antes e após o procedimento, com o objetivo de capacitar os profissionais da saúde para as situações de comunicação de más notícias aos pacientes e aos seus familiares, por meio de um curso de difusão gratuito, com duração de cinco horas. Participaram 79 profissionais da saúde, entre enfermeiros, estudantes de enfermagem, biólogos, farmacêuticos, estudantes de medicina, psicólogos, assistentes sociais e terapeutas ocupacionais. Foram utilizados como instrumentos de pesquisas: 1) o questionário Breaking Bad News sobre o protocolo SPIKES, que possui 13 questões objetivas. Este questionário foi analisado pela distribuição da porcentagem de respostas para cada questão; 2) o questionário de avaliação do curso de más notícias composto por 43 questões objetivas. Para a análise das variáveis quantitativas foram utilizadas as médias e as medianas para resumir as informações, e os desvios-padrão, mínimo e máximo, para indicar a variabilidade dos dados, além da porcentagem. A comparação entre as pontuações dos participantes na primeira e na segunda avaliação de habilidades de comunicação foi realizada pelo teste estatístico de McNemar. O teste estatístico não paramétrico Mann-Whitney foi utilizado para comparar a relação entre a idade dos participantes e as respostas do questionário de avaliação do curso de más notícias. A comparação entre a idade e a pontuação total dos participantes na avaliação de conteúdo do curso foi feita pelo coeficiente de correlação de Spearman. Para todos os testes assumiu-se o nível de significância em 5%. A idade dos participantes variou entre 18 e 55 anos, sendo a maioria do sexo feminino (83,5%) e da área da enfermagem (53,2% profissionais e 24,1% estudantes). Ademais, 57% dos participantes nunca tiveram qualquer formação sobre transmissão de más notícias, porém mesmo após este curso, oito pessoas continuaram afirmando que não tiveram formação alguma. A autoavaliação da capacidade de informar uma má notícia no pré-teste foi considerada boa por 18,2%; 20,8% consideraram-se ruins e 6,5%, péssimos, enquanto que o pós-teste 42,8% consideraram-se bons, 11,7%, ruins e 2,6%, péssimos. O conforto do profissional neste momento variou de 21,8% para 7,7% no item absolutamente desconfortável, e de 6,4% para 14,1% no item confortável. Após o conhecimento sobre o protocolo SPIKES, 92,3% acreditam em sua aplicabilidade na prática clínica.Quanto à estratégia utilizada pelos entrevistados em sua prática clínica, o item mostrou que \"um plano ou estratégia consistente\" apresentou frequências de 21,9% no pré-teste e 51,56% no pós-teste. Os elementos do protocolo SPIKES apontados como de maiores facilidades entre os participantes no pré-teste foi o local da notícia e a verificação da compreensão de tudo o que foi dito, 30,6% e 28,6%, ao passo que no pós-teste o item mais escolhido foi a escolha do ambiente (53,06%). A relação entre idade e conhecimento do protocolo SPIKES teve apenas um item que apresentou significância. Concluiu-se, portanto, que o treinamento de habilidades de comunicação de más notícias atingiu seus objetivos melhorando o conhecimento e a aptidão dos profissionais da saúde. Evidenciou-se também que a educação em comunicação na área da saúde mantém-se falha, bem como é escassa a difusão de protocolos que abarquem esta difícil tarefa destinada aos profissionais da saúde. O pós-teste mostrar-se-ia mais eficaz caso fosse aplicado após o retorno dos profissionais aos seus pacientes e o uso das técnicas apreendidas. Sugerimos a adoção de educação permanente aos atuantes na área da saúde / A quasi-experimental study with an intervention group evaluated before and after the procedure, in order to enable health professionals to communicate bad news to patients and their families through a free course of five hours duration. We evaluated 79 health professionals, including nurses, nursing students, biologists, pharmacists, medical students, psychologists, social workers and occupational therapists. The following research tools were used: 1) the Breaking Bad News questionnaire about the SPIKES protocol, which has 13 objective questions. This questionnaire was analyzed by the distribution of the percentage of answers for each question; 2) the evaluation questionnaire of the course of bad news composed by 43 objective questions. For the quantitative analysis we used the means and the medians to summarize the information, and the standard deviations, minimum and maximum to indicate the variability of the data, besides the percentage. The comparison between the scores of participants in the first and second evaluation of communication skills was performed by the McNemar statistical test. The Mann-Whitney non-parametric statistical test was used to compare the relationship between the age of the participants and the responses of the evaluation questionnaire of the course of bad news. The comparison between the age and the total score of the participants in the evaluation of course content was made by the Spearman correlation coefficient. For all tests, the level of significance was set at 5%. The participants\' ages ranged from 18 to 55 years old, with most females (83.5%) and nursing (53.2% professionals and 24.1% students). In addition, 57% of the participants never had any training on the transmission of bad news, but even after this course, eight people continued to claim that they had no training. The self-reported ability to report bad news in the pre-test was considered good by 18.2%; 20.8% were considered bad and 6.5% were poor, while the post-test 42.8% were considered good, 11.7%, bad and 2.6% Lousy. The comfort of the professional at the time ranged from 21.8% to 7.7% on the uncomfortable item and from 6.4% to 14.1% on the comfortable item. After knowing about the SPIKES protocol, 92.3% believe in its applicability in clinical practice. Regarding the strategy used by the interviewees in their clinical practice, the item showed that \"a consistent plan or strategy\" presented frequencies of 21.9% in the pre-test and 51.56% in the post-test. The elements of the SPIKES protocol identified as greatest facilities among participants in the pre-test were the news site and the verification of the understanding of all that was said 30.6% and 28.6%, while in the post-test the most chosen item was the choice of the environment (53.06%). The relationship between age and knowledge of the SPIKES protocol had only one item that presented significance. It was concluded, therefore, that communication education in the health area remains flawed, as well as the dissemination of protocols that cover this difficult task for health professionals. The post-test would be more effective if it were applied after the return of the professionals to their patients and the use of the seized techniques. We suggest the adoption of permanent education to those in the health area