Abstract
ABSTRACTObjective: To describe the reports of parents of newborns (NB) with congenital malformations hospitalized in a Neonatal Intensive Care Unit (NICU) who received bad news, in order to identify the issues related to the perception of bad news given adequately or inadequately.Methods: A cross-sectional study was conducted from January to October 2018, in which parents of newborns with congenital malformations hospitalized in NICUs were interviewed at visiting hours, according to inclusion criteria. The questionnaire had semi-structured questions related to reception of bad news. Analysis of the data was descriptive.Results: 28 mothers and two fathers were interviewed and 16 (53.3%) reported having had at least one bad news in the NICU. Of those, 10 (62.5%) considered appropriate the way in which the news was given. The justifications were: sincerity of the professional, delicacy to give the news, giving hope to the family, use of appropriate words and demonstration of caring about the newborn. Six participants (37.5%) considered inadequate the way of breaking bad news. The reasons were: unpreparedness and lack of knowledge about the child’s case, use of difficult language, haste or anxiety and discouragement of family hope. Most of the news was given by a professional alone, often by a medical resident.Conclusions: The communication of bad news was considered adequate by the parents, although this perception was not unanimous. This study, therefore, indicates that it is necessary to improve the communication of bad news in this NICU. Training professionals can assist in this process.
Highlights
The need for specialized assistance in Semi-Intensive Care Units or Neonatal Intensive Care Units (NICUs) brings a lot of anxiety, anguish and uncertainty to newborns’ (NB) families, who, during pregnancy, expected a healthy child.[1,2,3,4,5] Frequent and adequate communication between the team and family members is essential to ensure understanding about what is happening with the newborn[2] and to reduce this stress.[3,4]The NICU environment is full of sounds, words, images and odors that can cause discomfort or strangeness to families, especially those that are newly admitted.[1]
A prospective cross-sectional study was conducted in which parents of newborns with congenital malformations admitted from January 3 to October 24, 2018 at the Instituto da Criança, in the neonatal intensive care center-2 (CTIN-2) were interviewed
Six interviewees had already had the experience of accompanying a child in the NICU
Summary
The need for specialized assistance in Semi-Intensive Care Units or Neonatal Intensive Care Units (NICUs) brings a lot of anxiety, anguish and uncertainty to newborns’ (NB) families, who, during pregnancy, expected a healthy child.[1,2,3,4,5] Frequent and adequate communication between the team and family members is essential to ensure understanding about what is happening with the newborn[2] and to reduce this stress.[3,4]The NICU environment is full of sounds, words, images and odors that can cause discomfort or strangeness to families, especially those that are newly admitted.[1]. In contrast to the large amount of structural resources and technology available, little attention is paid to communication.[2,6] In the United Kingdom and other European countries, the main complaint of families has been related to this issue: the lack of appropriate communication and information given regularly.[2,3,6] There are few studies carried out in Latin American countries about communication in NICUs,[7,8,9] and those that exist show the need to improve and adapt this aspect of care
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