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CC BY 4.0 · Rev Bras Ginecol Obstet 2022; 44(06): 621-628
DOI: 10.1055/s-0042-1742316
Review Article

Breaking Bad News in Obstetrics and Gynecology: We Must Talk About It

Más notícias em obstetrícia e ginecologia: Devemos falar sobre isso
Luísa Silva de Carvalho Ribeiro 
1   Department of Obstetrics and Gynecology , Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
,
Bárbara Flecha D'Abreu 
1   Department of Obstetrics and Gynecology , Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
,
Aline Evangelista Santiago 
2   Department of Tocogynecology, Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, SP, Brazil
,
Eduardo Batista Cândido 
1   Department of Obstetrics and Gynecology , Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
,
Gustavo Salata Romão 
3   Faculdade de Medicina, Universidade de Ribeirão Preto, Ribeirão Preto, SP, Brazil
,
Marcos Felipe Silva de Sá 
4   Department of Obstetrics and Gynecology, Faculdade de Medicina, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Agnaldo Lopes da Silva Filho 
1   Department of Obstetrics and Gynecology , Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Abstract

Breaking bad news is common in obstetrics and gynecology (ob-gyn). However, it is difficult, and few doctors receive training on how to deal with this situation. This narrative review aims to gather, analyze, and synthesize part of the knowledge on the area, focused on Ob-Gyn. Among the 16 selected articles, two are randomized controlled intervention studies, and most studies refer to obstetrics. The results found by us pointed out that simulation, feedback/debriefing, lectures, and protocols could improve doctors' performance in communicating bad news. For patients, the context and how the information is transmitted seem to impact more than the content of the news. Ob-Gyn doctors could benefit from specific protocols and education, given the specialty's particularities. There is a lack of evidence about the most effective way to conduct such training. Finding validated ways to quantify and classify studies' results in the area, which would allow for the objective analysis of outcomes, is one of the biggest challenges concerning this topic.

Resumo

Dar más notícias é comum em obstetrícia e ginecologia. Porém, é difícil e poucos médicos recebem treinamento sobre como lidar com essa situação. Esta revisão narrativa tem como objetivo reunir, analisar e sintetizar parte do conhecimento sobre a área, com foco na obstetrícia. Dentre os 16 artigos selecionados, dois são estudos de intervenção randomizados e controlados, e a maioria dos estudos refere-se à obstetrícia. Os resultados encontrados ressaltaram que simulação, feedback/entrevistas, palestras e protocolos podem melhorar o desempenho dos médicos na comunicação de más notícias. Para os pacientes, o contexto e como as informações são transmitidas parecem ter maior impacto do que o conteúdo das notícias. Os obstetras e ginecologistas poderiam se beneficiar de cursos e protocolos específicos, dadas as particularidades da especialidade. Faltam evidências sobre a forma mais eficaz de realizar esse treinamento. Encontrar formas validadas de quantificar e classificar os resultados dos estudos na área, permitindo uma análise objetiva dos resultados, é um dos maiores desafios neste tema.

Keywords

communication - bad news - obstetrics - gynecology - medical education

Palavras-chave

comunicação - más notícias - obstetrícia - ginecologia - educação médica


Publication History

Received: 16 June 2021

Accepted: 03 November 2021

Article published online:
12 July 2022

© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Nonino A, Magalhães SG, Falcão DP. Treinamento médico para comunicação de más notícias: revisão da literatura. Rev Bras Educ Med 2012; 36 (02) 228-233
    CrossrefPubMedSearch in Google Scholar
  • 2 Lino CA, Augusto KL, Oliveira RA, Feitosa LB, Caprara A. Uso do protocolo Spikes no ensino de habilidades em transmissão de más notícias. Rev Bras Educ Med 2011; 35 (01) 52-57
    CrossrefPubMedSearch in Google Scholar
  • 3 Coutinho F, Ramessur A. An overview of teaching communication of bad news in medical school: should a lecture be adequate to address the topic?. Acta Med Port 2016; 29 (12) 826-831
    CrossrefPubMedSearch in Google Scholar
  • 4 Pereira CR, Calônego MA, Lemonica L, Barros GA. The P-A-C-I-E-N-T-E Protocol: An instrument for breaking bad news adapted to the Brazilian medical reality. Rev Assoc Med Bras (1992) 2017; 63 (01) 43-49
    CrossrefPubMedSearch in Google Scholar
  • 5 Sombra Neto LL, Silva VL, Lima CD, de Melo Moura HT, Gonçalves AL, Pires AP. et al. Habilidade de comunicação da má notícia: o estudante de medicina está preparado?. Rev Bras Educ Med 2017; 41 (02) 260-268
    CrossrefPubMedSearch in Google Scholar
  • 6 Moore PM, Rivera S, Bravo-Soto GA, Olivares C, Lawrie TA. Communication skills training for healthcare professionals working with people who have cancer. Cochrane Database Syst Rev 2018; 7 (07) CD003751
    Search in Google Scholar
  • 7 Setubal MSV, Antonio MÂRGM, Amaral EM, Boulet J. Improving perinatology residents' skills in breaking bad news: a randomized intervention study. Rev Bras Ginecol Obstet 2018; 40 (03) 137-146
    Thieme ConnectPubMedSearch in Google Scholar
  • 8 Karkowsky CE, Landsberger EJ, Bernstein PS, Dayal A, Goffman D, Madden RC. et al. Breaking Bad News in obstetrics: a randomized trial of simulation followed by debriefing or lecture. J Matern Fetal Neonatal Med 2016; 29 (22) 3717-3723
    CrossrefPubMedSearch in Google Scholar
  • 9 Guerra FA, Mirlesse V, Baião AE. Breaking bad news during prenatal care: a challenge to be tackled. Ciênc Saúde Coletiva. 2011; 16 (05) 2361-2367
    CrossrefPubMedSearch in Google Scholar
  • 10 Lim CE, Cheng NC. Clinician's role of psychological support in helping parents and families with pregnancy loss. J Aust Tradit-Med Soc 2011; 17 (04) 215-217
    PubMedSearch in Google Scholar
  • 11 Nuzum D, Meaney S, O'Donohue K. Communication skills in Obstetrics: what can we learn from bereaved parents?. Ir Med J 2017; 110 (02) 512
    PubMedSearch in Google Scholar
  • 12 Greiner AL, Conklin J. Breaking bad news to a pregnant woman with a fetal abnormality on ultrasound. Obstet Gynecol Surv 2015; 70 (01) 39-44
    CrossrefPubMedSearch in Google Scholar
  • 13 Romm J. Breaking bad news in obstetrics and gynecology: educational conference for resident physicians. Arch Women Ment Health 2002; 5 (04) 177-179
    CrossrefPubMedSearch in Google Scholar
  • 14 Leone D, Menichetti J, Barusi L. et al. Breaking bad news in assisted reproductive technology: a proposal for guidelines. Reprod Health 2017; 14 (01) 87
    CrossrefPubMedSearch in Google Scholar
  • 15 Lalos A. Breaking bad news concerning fertility. Hum Reprod 1999; 14 (03) 581-585
    CrossrefPubMedSearch in Google Scholar
  • 16 Kuroki LM, Zhao Q, Jeffe DB, Powell MA, Hagemann AR, Thaker PH. et al. Disclosing a diagnosis of cancer: considerations specific to gynecologic oncology patients. Obstet Gynecol 2013; 122 (05) 1033-1039
    CrossrefPubMedSearch in Google Scholar
  • 17 Zanetti-Dällenbach R, Tschudin S, Lapaire O, Holzgreve W, Wight E, Bitzer J. Psychological management of pregnancy-related breast cancer. Breast 2006; 15 (Suppl. 02) S53-S59
    CrossrefPubMedSearch in Google Scholar
  • 18 Alkazaleh F, Thomas M, Grebenyuk J, Glaude L, Savage D, Johannesen J. et al. What women want: women's preferences of caregiver behavior when prenatal sonography findings are abnormal. Ultrasound Obstet Gynecol 2004; 23 (01) 56-62
    CrossrefPubMedSearch in Google Scholar
  • 19 Cockburn J, Walters WA. Communication between doctors and patients. Curr Obstet Gynaecol 1999; 9 (01) 34-40
    CrossrefPubMedSearch in Google Scholar
  • 20 Karkowsky CE, Chazotte C. Simulation: improving communication with patients. Semin Perinatol 2013; 37 (03) 157-160
    CrossrefPubMedSearch in Google Scholar
  • 21 Setubal MSV, Gonçalves AV, Rocha SR, Amaral EM. Breaking bad news training program based on video reviews and SPIKES strategy: what do perinatology residents think about it?. Rev Bras Ginecol Obstet 2017; 39 (10) 552-559
    Thieme ConnectPubMedSearch in Google Scholar
  • 22 Johnson J, Arezina J, McGuinness A, Culpan AM, Hall L. Breaking bad and difficult news in obstetric ultrasound and sonographer burnout: Is training helpful?. Ultrasound 2019; 27 (01) 55-63
    CrossrefPubMedSearch in Google Scholar
  • 23 Romão GS, Silva de Sá MF. Competency-based training and the competency framework in gynecology and obstetrics in Brazil. Rev Bras Ginecol Obstet 2020; 42 (05) 272-288
    Thieme ConnectPubMedSearch in Google Scholar