Clear information, privacy vital when breaking bad news to patients

Little attention has been paid to the wishes and needs of female patients regarding fetal abnormalities

Women whose ultrasounds show fetal abnormalities want clear information about results as quickly and as empathetically as possible, says a new study by researchers at U of T, Mount Sinai Hospital and York University.

“Unfortunately, we still see examples of bad news being given quite badly,” says Dr. Rory Windrim, a U of T professor in the Faculty of Medicine and an obstetrician and specialist in high-risk pregnancies at Mount Sinai Hospital. “To better understand how to communicate bad news, we felt we should ask patients what they want.” The study appears in the March issue of Ultrasound in Obstetrics and Gynecology.

While much has been written about how health-care providers should communicate bad news, little attention has been paid to the wishes and needs of patients receiving it. The extent of psychological trauma experienced by women who learn their fetuses have abnormalities is greatly influenced by the way the news is delivered, previous research has shown.

In their study, Windrim and his colleagues examined the experiences of 117 women referred to Mount Sinai in 2000 who were informed of adverse pregnancy complications after undergoing an ultrasound. Two-thirds of the women were referred to the perinatal centre with fetal abnormalities; the remainder had other obstetric complications.

Their research shows that quality of information – clear, understandable facts, options and details on follow-up care – is most important to recipients. Women also want privacy when receiving the news and empathy from the person delivering it.

As a result of the study, Windrim hopes institutions and health-care providers will be better equipped and motivated to develop guidelines for effective and considerate communication of bad news.

Other researchers involved in the study were Fawaz Alkazeleh, a former U of T fellow; Louise Glaude and Diane Savage of Mount Sinai; Melanie Caetano and Martin Thomas of York University; and parent advocate Jennifer Johannesen.

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Elaine Smith University of Toronto

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