{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T11:42:30Z","timestamp":1792237350448,"version":"4.4.0"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Breaking bad news (BBN) is a cognitively and emotionally demanding communication task for paediatric nurses, yet empirical evidence on its determinants remains scarce. This study aimed to assess the current status of BBN competence and identify demographic, professional, and training\u2010related factors associated with this competence among paediatric nurses.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A cross\u2010sectional survey was conducted among 382 paediatric nurses using a Breaking Bad News Ability Scale. The scale demonstrated good psychometric properties (Cronbach's\n \u03b1<\/jats:italic>\n \u2009=\u20090.91; test\u2013retest reliability\u2009=\u20090.85; S\u2010CVI\/Ave\u2009=\u20090.94). The instrument comprises five dimensions: pre\u2010disclosure preparation, communication strategy, empathic response, child\/family specificity, and communication\/self\u2010reflection. The study was designed and reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Univariate analysis, Pearson's correlation, and multiple linear regression were performed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Total scores range from 20 to 100; each of the five dimensions ranges from 4 to 20. Higher scores indicate greater competence. The mean total score was 69.0\u2009\u00b1\u20096.3, indicating a moderate level of ability. Empathic response scored highest (14.2\u2009\u00b1\u20092.0), whereas pre\u2010disclosure preparation (13.5\u2009\u00b1\u20092.2) and child\/family specificity (13.6\u2009\u00b1\u20092.2) were the lowest\u2010performing dimensions. Univariate analysis revealed significant differences by age, educational attainment, professional title, years of paediatric nursing experience, communication training within the preceding 6\u2009months, and clinical department (all\n p<\/jats:italic>\n \u2009<\u20090.01). Recent communication training demonstrated the strongest positive correlation (\n r<\/jats:italic>\n \u2009=\u20090.419,\n p<\/jats:italic>\n \u2009<\u20090.001), followed by years of experience (\n r<\/jats:italic>\n \u2009=\u20090.392) and professional title (\n r<\/jats:italic>\n \u2009=\u20090.376). Multiple linear regression (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090.394,\n p<\/jats:italic>\n \u2009<\u20090.001) identified recent training (\n b<\/jats:italic>\n \u2009=\u20092.09,\n p<\/jats:italic>\n \u2009<\u20090.001), professional title (\n b<\/jats:italic>\n \u2009=\u20091.20,\n p<\/jats:italic>\n \u2009=\u20090.002), years of experience (\n b<\/jats:italic>\n \u2009=\u20090.29,\n p<\/jats:italic>\n \u2009=\u20090.007), and age (\n b<\/jats:italic>\n \u2009=\u20090.15,\n p<\/jats:italic>\n \u2009=\u20090.013) as independent positive predictors.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Paediatric nurses demonstrated moderate BBN competence, with notable deficiencies in pre\u2010disclosure preparation and family\u2010specific tailoring.<\/jats:p>\n <\/jats:sec>\n \n Patient or Public Contribution<\/jats:title>\n Communication training within the preceding 6\u2009months emerged as the strongest modifiable predictor. Nurses in intensive care settings, despite frequent exposure to high\u2010stakes disclosures, warrant targeted competency development.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jocn.70579","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T11:20:56Z","timestamp":1792236056000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Navigating Difficult Conversations: Factors Influencing Paediatric Nurses' Bad News Delivery and Their Professional Coping Responses"],"prefix":"10.1111","author":[{"given":"Xuetang","family":"Zhao","sequence":"first","affiliation":[{"name":"SICU Children's Hospital of Nanjing Medical University Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aijuan","family":"Fan","sequence":"additional","affiliation":[{"name":"SICU Children's Hospital of Nanjing Medical University Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2939-6621","authenticated-orcid":false,"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[{"name":"SICU Children's Hospital of Nanjing Medical University Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"issue":"4","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","DOI":"10.3390\/healthcare8040501","article-title":"Breaking Bad News, a Pertinent Yet Still an Overlooked Skill: An International Survey Study","volume":"8","author":"Alshami A.","year":"2020","journal-title":"Healthcare (Basel)"},{"key":"e_1_2_13_3_1","doi-asserted-by":"crossref","DOI":"10.1177\/26323524251409345","article-title":"Development and Pilot Evaluation of a Psychosocial Oncology and Palliative Care Training Program for Nurses in Cameroon","volume":"20","author":"Bassah N.","year":"2026","journal-title":"Palliative Care Social Practice"},{"issue":"9","key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"528","DOI":"10.3928\/01484834-20220705-08","article-title":"Breaking Bad News via Telehealth: Simulation Training for Nurse Practitioner Students","volume":"61","author":"Berta M.","year":"2022","journal-title":"Journal of Nursing Education"},{"issue":"1","key":"e_1_2_13_5_1","doi-asserted-by":"crossref","DOI":"10.3390\/nursrep16010004","article-title":"Healthcare Professionals Describe Difficulties Encountered When Breaking Bad News to Oncology Patients: An Italian Observational Study","volume":"16","author":"Botti S.","year":"2025","journal-title":"Nursing Reports"},{"issue":"1","key":"e_1_2_13_6_1","first-page":"18","article-title":"A Study on Communication of Bad News Between Doctors and Patients From the Perspective of Conversation Analysis","volume":"6","author":"Chen Q.","year":"2023","journal-title":"Narrative Medicine"},{"issue":"2","key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.7748\/ncyp.2025.e1560","article-title":"Stress and Resilience in Children's Nursing: A Review of the Evidence","volume":"38","author":"Clark C.","year":"2026","journal-title":"Nursing Children and Young People"},{"issue":"4","key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1093\/oncolo\/oyaf039","article-title":"A Scoping Review of Clinical Communication in Cancer Care in Africa","volume":"30","author":"DeBoer R. J.","year":"2025","journal-title":"Oncologist"},{"issue":"3","key":"e_1_2_13_9_1","first-page":"2","article-title":"\u2018Five\u2010Dimensional Communication\u2019 Strategy for Communicating Bad News Between Doctors and Patients From the Perspective of Interpersonal Communication\u2014Thinking Based on the Window Movement Law of the \u2018Yohari Window\u2019","volume":"24","author":"Ding C.","year":"2024","journal-title":"Journal of Yangtze Normal University"},{"issue":"6","key":"e_1_2_13_10_1","doi-asserted-by":"crossref","first-page":"26","DOI":"10.7748\/en.2024.e2194","article-title":"Exploring the Experiences of Healthcare Professionals When Breaking Bad News in Major Trauma Care","volume":"32","author":"Griffiths A.","year":"2024","journal-title":"Emergency Nurse"},{"issue":"2","key":"e_1_2_13_11_1","doi-asserted-by":"crossref","DOI":"10.1111\/nicc.13119","article-title":"Breaking Bad News: Comparing the Perception of the Role, Barriers and Experiences of Neonatal Intensive Care and Well\u2010Baby Nursery Nurses","volume":"30","author":"Haim\u2010Eli L.","year":"2025","journal-title":"Nursing in Critical Care"},{"issue":"2","key":"e_1_2_13_12_1","first-page":"271","article-title":"Analysis of the Current Situation and Influencing Factors of ICU Nurses Ability to Inform Bad News","volume":"25","author":"Han W.","year":"2025","journal-title":"China Nursing Management"},{"key":"e_1_2_13_13_1","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.pedn.2026.01.047","article-title":"Pediatric Intensive Care Unit Nurses' Reflective Experience in Caring for Maltreated Children and Adolescents in Taiwan: A Narrative Qualitative Study","volume":"88","author":"Huang P. 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