Entrega de malas noticias en la práctica clínica

Herrera, Andrea; Ríos, Matías; Manríquez, José Manuel; Rojas, Gonzalo

doi:10.4067/s0034-98872014001000011

Cited by 22 publications

(27 citation statements)

References 54 publications

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“…Nevertheless, the present study confirms prior research findings that medical personnel need to improve their communication skills and, above all, that the unpredictability that still characterises ultrasound screening for chromosomopathies and/or foetal malformations commonly makes it necessary to supply information abruptly and in a way that may seem improvised and insensitive (Greiner & Conklin, 2015). The clinical relationship between health professionals and their patients is generally shaped by the periodic tests and examinations performed to obtain prenatal diagnoses, and the success of this relationship largely depends on the physician's ability to interact with the patient and to engage in useful dialogue (Herrera et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Experiences and outcomes following diagnosis of congenital foetal anomaly and medical termination of pregnancy: A phenomenological study

Atienza-Carrasco

Abad

Padilla‐Ruiz

et al. 2020

Journal of Clinical Nursing

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Aim To determine and describe the experiences of pregnant women who receive a diagnosis of chromosomopathy and/or foetal malformation during a prenatal check‐up and who decide to legally terminate the pregnancy. Background When a pregnancy is terminated, the woman must cope with frustrated motherhood. The psychological consequences of this will largely depend on the care and support provided by health professionals. When a congenital anomaly is diagnosed, a patient‐centred communication helps understanding, influences adaptation to the new situation and ensures the person concerned has sufficient (autonomy or independence or ability) to make appropriate decisions. Methods A qualitative study, based on a phenomenological approach, was carried out through nonparticipant observation and semi‐structured interviews with 27 obstetric patients. NVivo 11 software was used, and content analysis was performed. The manuscript was developed using the COREQ guidelines to inform qualitative studies. Results The clinical relationship may be affected by communication problems such as patients' perceptions of scarce emotional involvement by obstetricians, by poor psychosocial support during the termination of the pregnancy and by insufficient follow‐up after discharge. Conclusion Nurses are in a privileged position to promote the empowerment of affected women. It is necessary to improve aspects related to the privacy of patients and the awareness and training of the interdisciplinary team in interpersonal communication. Post‐loss follow‐up is recommended to assess individual needs, thus facilitating an optimal approach to ease the grieving process. Relevance to clinical practice During the prenatal diagnosis, the existence of a fetal anomaly is emphasized, but support and follow up of the mother may be neglected; therefore, exhaustive knowledge about the obstetric history, the state of health and the expectations of patients is as important as a multidisciplinary team trained in counseling strategies and with a comprehensive care plan that covers all areas, especially those that control maternal emotions.

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Section: Discussionmentioning

confidence: 99%

Experiences and outcomes following diagnosis of congenital foetal anomaly and medical termination of pregnancy: A phenomenological study

Atienza-Carrasco

Abad

Padilla‐Ruiz

et al. 2020

Journal of Clinical Nursing

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“…7 They may consist of denial, deep distress, blame or fear of emotions, diseases and death. 4,5 Although some studies have stated that patients want honesty, compassion, care and affectivity, and to have their doubts clarified by their doctors, 3 they also expect not only professionalism and competence in clinical skills, but also effectiveness of communication. 8 However, this should not be done in a cold or careless manner.…”

Section: Introductionmentioning

confidence: 99%

“…1 The term "bad news" means any information that is given to patients and their families, which directly or indirectly reveals any negative or severe disorder that could change their future perspectives and vision of life. [2][3][4][5][6] Many difficulties that doctors have in breaking bad news can be explained by their fear of causing harm and suffering to their patients, and fear of being blamed for or having to deal with their patients' emotions. All of these emotions may be unpredictable and unexpected.…”

Section: Introductionmentioning

confidence: 99%

“…The last but not least important step "S", strategy and summary, is the time to suggest what the treatment should be, and what the prognosis is, and also to summarize everything that has been said, in order to check that patient has understood it. [2][3][4][5][6] Studies have shown that doctors and healthcare professionals who take a training course on breaking bad news do not depend exclusively on their own experiences or observations, and they feel more comfortable and confident when communicating such information. Thus, holding workshops that teach techniques for breaking bad news will produce better prepared and more confident professionals.…”

Section: Introductionmentioning

confidence: 99%

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Breaking bad news: doctors’ skills in communicating with patients

2017

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CONTEXT AND OBJECTIVE: Breaking bad news is one of doctors' duties and it requires them to have some skills, given that this situation is difficult and distressful for patients and their families. Moreover, it is also an uncomfortable condition for doctors. The aim of this study was to evaluate doctors' capacity to break bad news, ascertain which specialties are best prepared for doing this and assess the importance of including this topic within undergraduate courses. DESIGN AND SETTING: Observational cross-sectional quantitative study conducted at a university hospital in Belo Horizonte (MG), Brazil. METHODS: This study used a questionnaire based on the SPIKES protocol, which was answered by 121 doctors at this university hospital. This questionnaire investigated their attitudes, posture, behavior and fears relating to breaking bad news. RESULTS:The majority of the doctors did not have problems regarding the concept of bad news. Nevertheless, their abilities diverged depending on the stage of the protocol and on their specialty and length of time since graduation. Generally, doctors who had graduated more than ten years before this survey felt more comfortable and confident, and thus transmitted the bad news in a better conducted manner. CONCLUSION: Much needs to be improved regarding this technique. Therefore, inclusion of this topic in undergraduate courses is necessary and proposals should be put forward and verified.RESUMO CONTEXTO E OBJETIVO: Dar más notícias, além de dever do médico, requer certas habilidades de sua parte, por se tratar de situação difícil e angustiante para o paciente e seus familiares, assim como desconfortável para os profissionais da saúde. O objetivo deste estudo é avaliar a capacidade dos médicos em dar más notícias, assim como as especialidades mais preparadas e a importância da inclusão do tema para a graduação. TIPO DE ESTUDO E LOCAL: Estudo observacional, transversal, quantitativo, realizado em hospital universitário de Belo Horizonte, Minas Gerais, Brasil. MÉTODOS: Este estudo utilizou de questionário baseado no protocolo SPIKES que foi respondido por 121 médicos deste hospital universitário. O questionário investigou suas atitudes, posturas, modos e medos em relação a dar más notícias. RESULTADOS: A maioria dos médicos não teve problemas quanto ao conceito de más notícias, contudo, as habilidades divergiram dependendo da etapa do protocolo, assim como quanto a especialidade e tempo de formado. De modo geral, os médicos formados há mais de 10 anos se sentem mais confortáveis e confiantes, e transmitem tal informação de maneira mais bem conduzida. CONCLUSÃO: Muito se tem a aprimorar em relação a essa técnica. Desse modo, a inclusão do tema durante a graduação é necessária e propostas devem ser sugeridas e averiguadas.

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“…O protocolo SPIKES é baseado em habilidades e na boa prática médica para abordar más notícias e descreve seis passos a serem seguidos para minimizar a ansiedade do mensageiro e atender de maneira integral o paciente e sua família 15,16 .…”

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Comunicação de más notícias em obstetrícia: impacto de treinamento institucional na percepção dos profissionais de saúde

Oliveira¹

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Entrega de malas noticias en la práctica clínica

Abstract: (Rev Med Chile 2014; 142: 1306-1315

Cited by 22 publications

References 54 publications

Experiences and outcomes following diagnosis of congenital foetal anomaly and medical termination of pregnancy: A phenomenological study

Experiences and outcomes following diagnosis of congenital foetal anomaly and medical termination of pregnancy: A phenomenological study

Breaking bad news: doctors’ skills in communicating with patients

Comunicação de más notícias em obstetrícia: impacto de treinamento institucional na percepção dos profissionais de saúde

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