Physicians’ experiences when communicating the diagnosis of infants’ disability to parents

Authors

  • Valquíria Luisada Universidade Presbiteriana Mackenzie, Centro Universitário Faculdades Metropolitanas Unidas
  • Geraldo A. Fiamenghi-Jr University of Edinburgh, Centro de Estudos em Psicologia
  • Sueli G. de Carvalho Universidade Presbiteriana Mackenzie.
  • Elisângela A. Assis-Madeira Universidade Presbiteriana Mackenzie, Centro Universitário do Leste de Minas Gerais
  • Silvana M. Blascovi-Assis UNICAMP, Universidade Presbiteriana Mackenzie

DOI:

https://doi.org/10.15448/1983-652X.2015.3.21769

Keywords:

diagnosis, disabled infants, emotions, physician-patient relations.

Abstract

Objective: This study aimed to investigate the feelings and experiences of physicians when breaking the news of a disability to parents, at the child’s birth, as well as the skills and qualifications to perform that task.
Material and Methods: The qualitative exploratory study used a semi-structured interview. Research was conducted with 10 physicians, obstetricians and neonatologists in São Paulo. Interviews were analyzed and results discussed using three different categories: News, Feelings, and Professional Qualification.
Results: Physicians report difficulties in communicating the parents about their infants’ disabilities and think on different strategies, such as talking to the couple, talking to the mother only; talking immediately after birth, waiting for some time before breaking the news; refer sadness and lack of training while in medical studies.
Conclusion: Inadequate and inefficient approaches were pointed, as well as the lack of skills and difficulties in communicating the news, associated to nonexistence of academic qualification to complete those duties. It is concluded that the main feelings are sadness, anxiety and solidarity, with physical and emotional consequences for the professional, as well as to their parents’ families.

Author Biography

Valquíria Luisada, Universidade Presbiteriana Mackenzie, Centro Universitário Faculdades Metropolitanas Unidas

Enfermeira (UNIFESP), Mestre em Distúrbios do Desenvolvimento (Universidade Presbiteriana Mackenzie).

References

Fiamenghi-Jr GA, Messa AA. Pais, filhos e deficiência: estudos sobre as relações familiares. Psicol Ciênc Prof. 2007; 27(2):236-245. http://dx.doi.org/10.1590/S1414-98932007000200006

Vash CL. Enfrentando a deficiência: a manifestação, a psicologia, a reabilitação. São Paulo: Pioneira; 1988.

Cunha MAFV, Blascovi-Assis SM, Fiamenghi-Jr GA. Impacto da notícia da síndrome de Down para os pais: histórias de vida. Ciênc. Saúde Coletiva. 2010; 15(2):444-451. http://dx.doi.org/10.1590/s1413-81232010000200021

Falkenbach AP, Drexsler G, Werler V. A relação mãe/criança com deficiência: sentimentos e experiências. Ciênc. Saúde Coletiva. 2008; 13:(2):2065-2073. http://dx.doi.org/10.1590/S1413-

Fallowfield L, Jenkins V. Communicating sad, bad, and difficult news in medicine. Lancet. 2004; 19:363-312. http://dx.doi.org/10.1016/s0140-6736(03)15392-5

Hammond M, McLean E. What parents and carers think medical students should be learning about communication with children and families. Patient Educ Couns. 2009; 76:368-375. http://dx.doi.org/10.1016/j.pec.2009.07.020

Carmel S, Glick SM. Compassionate empathic physicians: personality traits and social organizational factors that enhance or inhibit this behavior pattern. Soc Sci Med. 1996; 43(8):1253-1261. http://dx.doi.org/10.1016/0277-9536(95)00445-9

Bardin L. Análise de conteúdo. Lisboa: Edições 70; 2000.

Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES: a six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000; 5:302-311. http://dx.doi.org/10.1634/theoncologist.5-4-302

Sunelaitis CR, Arruda DC, Marcom SS. A repercussão de um diagnóstico de síndrome de Down no cotidiano familiar: perspectiva da mãe. Acta Paul Enferm. 2007; 20(3):264-271. http://dx.doi.org/10.1590/S0103-21002007000300004

Jurkovich GJ, Pierce B, Pananen L, Rivara FP. Giving bad news: the family perspective. J Trauma. 2000; 48(5):865-873. http://dx.doi.org/10.1097/00005373-200005000-00009

Golder WN. When you must give a baby’s parents terrible news. Med. Econ. 1996; 73(3):247.

Farrel MH, La Pean A, Ladouceur I. Content of communication by pediatric residents after newborn genetic screening. Pediatrics. 2005; 116:1492-1498. http://dx.doi.org/10.1542/peds.2004-2611

Perdicaris AME. E agora doutor?: velhos caminhos e novas fronteiras na comunicação médica. 2ª ed. rev. Barueri (SP): Minha Editora/Manole; 2012.

Ministério da Saúde (BR). Instituto Nacional do Câncer. Comunicação de notícias difíceis: compartilhando desafios na atenção à saúde. Rio de Janeiro: INCA, 2010.

Ceccim RB. Equipe de saúde: a perspectiva entre-disciplinar na produção de atos terapêuticos. In: Pinheiro R, Mattos RA, organizadores. Cuidado: as fronteiras da integralidade. São Paulo: Hucitec/Abrasco; 2004.

Lino CA, Augusto KL, Oliveira RAS, Feitosa LB, Caprara A. Uso do protocolo SPIKES no ensino de habilidades em transmissão de más notícias. Rev Bras Educ Med. 2011; 35(1):52-57. http://dx.doi.org/10.1590/S0100-55022011000100008

Perosa GB, Ranzani PM. Capacitação do médico para comunicar más notícias à criança. Rev Bras Educ Med. 2008; 32(4):468-473. http://dx.doi.org/10.1590/S0100-55022008000400009

Pupo Filho RA. Síndrome de Down. E agora doutor? Rio de Janeiro: WVA; 1996.

Published

2016-01-21

Issue

Section

Original Articles