Breaking bad news to antenatal patients with strategies to lessen the pain: a qualitative study

Abstract

Background: To consider the thoughts and actions of healthcare personnel in situations when an adverse prenatal diagnosis must be communicated, including appropriate strategies and skills to respond to information needs and to manage the emotional responses of patients. Methods: Descriptive qualitative study using non-participant observation and semi-structured interviews to analyse the discourses of physicians, midwives, nurses and nursing assistants who provide healthcare to obstetric patients. Results: There may be barriers to effective communication between healthcare personnel and patients, depending on the characteristics of the persons involved, the organisation of healthcare, biotechnological progress and cultural factors. Conclusions: The human quality of healthcare has deteriorated due to excessive workloads and to the growing role played by technology. In order to improve communication, more attention should be paid to human and spiritual dimensions, prioritising empathy, authenticity and non-judgmental listening. An appropriate model of clinical relationship should be based on shared decision making, clarifying the functions of the multidisciplinary team to alleviate a mother's suffering when a pregnancy is interrupted. To do so, protocols should be implemented to ensure the provision of comprehensive care, not only addressing biological issues but also providing psychosocial attention. Finally, training should be provided to healthcare staff to enhance their social skills and cultural competence. This study identifies potential improvements in the interventions made by healthcare personnel and in the organisation of the institution, concerning the attention provided to pregnant women when an adverse prenatal diagnosis must be communicated.

The experience of speech–language therapists and audiologists when delivering bad news: A qualitative analysis

“…Most of the participants agreed that information should be transmitted gradually (Atienza‐Carrasco et al . 2018). Similarly, a focus group discussion and individual interviews were investigated (Oikonomidou et al .…”

“…The importance of phrasing the message properly in healthcare settings is stressed in previous studies. For example, physicians, midwives, and nurses were interviewed about their opinions and actions in situations when an adverse prenatal diagnosis must be communicated (Atienza-Carrasco et al 2018). One of the themes that emerged from the interviews pertained to the quality of conveying the news.…”

“…One of the themes that emerged from the interviews pertained to the quality of conveying the news. Most of the participants agreed that information should be transmitted gradually (Atienza-Carrasco et al 2018). Similarly, a focus group discussion and individual interviews were investigated (Oikonomidou et al 2017) for the purpose of analysing the self-reported practices of doctors on breaking bad news.…”

Neonatal death: supporting bereaved mothers

“…Although fetal death is common, HCP tend not to listen to their selves while breaking news to the mother which leads her to be emotionally distant. This inability to communicate leads to distrust, conflicts and dissatisfaction with the Quality of care which shows the importance of formal training in breaking bad news since it’s a skill to be learnt [12, 16, 17].…”

Improving the way healthcare professionals deliver different news to families during pregnancy or at birth: a qualitative study

“…Often HCPs have learnt to deliver different news from the 'see-one-do-one' approach. This is limited because of the variation in the skills of the senior HCPs observed by junior colleagues (Kim et al, 2016;Atienza-Carrasco et al, 2018). Simulations, reflective practice, debriefing and lectures have been used to teach HCPs how to deliver different news in the paediatrics and obstetric settings (Karkowsky et al, 2016;Kim et al, 2016).…”