Breaking bad news (BBN) is a necessary component of communication in health care. When
health care practitioners (HCPs) communicate illnesses of a serious nature with Indigenous
people, they often do not do so in a culturally safe way, and this can perpetuate health inequities
and catalyze poor health outcomes, which are often linked to Indigenous historical trauma. In
this integrative review I sought to analyze and synthesize the published experiences of
Indigenous adults from Canada, the United States, New Zealand, and Australia with BBN
conversations. I included twelve qualitative studies ranging from 1999 to 2022. I obtained the
studies through CINAHL (EBSCO), MEDLINE (OVID), manual reference list screening, and
citation tracking on Google Scholar. Themes identified were (a) Indigenous identity, (b) HCP
misinterpretation, (c) the meaning of words, (d) truth-telling and the prophetic power of words,
(e) indirect communication, and (f) the role of family. The review findings can inform HCPs’
understanding of potential communication errors and offer recommendations to improve
culturally safe BBN conversations. However, it is important to recognize that although
commonalities in experience exist, further research is needed to understand and address the
unique experiences of BBN in culturally diverse Indigenous tribes and nations.
