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Facilitators and Strategies for Breaking the News of an Intrauterine Death—A Mixed Methods Study among Obstetricians

(1) Background: The death of a baby in utero is a very sad event for both the affected parents and the caring doctors. By this study, we aimed to assess the tools, which may help obstetricians to overcome this challenge in their profession. (2) Methods: We conducted a cross-sectional online survey i...

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Autores principales: Muin, Dana Anais, Erlacher, Janina Sophie, Leutgeb, Stephanie, Felnhofer, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8625483/
https://www.ncbi.nlm.nih.gov/pubmed/34830629
http://dx.doi.org/10.3390/jcm10225347
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author Muin, Dana Anais
Erlacher, Janina Sophie
Leutgeb, Stephanie
Felnhofer, Anna
author_facet Muin, Dana Anais
Erlacher, Janina Sophie
Leutgeb, Stephanie
Felnhofer, Anna
author_sort Muin, Dana Anais
collection PubMed
description (1) Background: The death of a baby in utero is a very sad event for both the affected parents and the caring doctors. By this study, we aimed to assess the tools, which may help obstetricians to overcome this challenge in their profession. (2) Methods: We conducted a cross-sectional online survey in 1526 obstetricians registered with the Austrian Society of Obstetrics and Gynecology between September and October 2020. (3) Results: With a response rate of 24.2% (n = 439), our study shows that diagnosing fetal death was associated with a moderate to high degree of stress, regardless of position (p = 0.949), age (p = 0.110), gender (p = 0.155), and experience (p = 0.150) of physicians. Coping strategies for delivering the news of intrauterine death to affected parents were relying on clinical knowledge and high levels of self-confidence (55.0%; 203/369), support from colleagues (53.9%; 199/369), and debriefing (52.8%; 195/369). In general, facilitators for breaking bad news were more commonly cultivated by female obstetricians [OR 1.267 (95% CI 1.149–1.396); p < 0.001], residents [χ(2)(3;369) = 9.937; p = 0.019], and obstetricians of younger age [41 (34–50) years vs. 45 (36–55) years; p = 0.018]. External facilitators were most frequently mentioned, including professional support, training, professional guidance, time, parents’ leaflets, follow-up consultations, a supporting consultation atmosphere, and preparation before delivering the bad news. Internal facilitators included knowledge, empathy, seeking silence, reflection, privacy, and relief of guilt. (4) Conclusions: Communicating the diagnosis of fetal death evokes moderate to high levels of stress among obstetricians. Resources from both the professional and private environment are required to deal with this professional challenge on a personal level.
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spelling pubmed-86254832021-11-27 Facilitators and Strategies for Breaking the News of an Intrauterine Death—A Mixed Methods Study among Obstetricians Muin, Dana Anais Erlacher, Janina Sophie Leutgeb, Stephanie Felnhofer, Anna J Clin Med Article (1) Background: The death of a baby in utero is a very sad event for both the affected parents and the caring doctors. By this study, we aimed to assess the tools, which may help obstetricians to overcome this challenge in their profession. (2) Methods: We conducted a cross-sectional online survey in 1526 obstetricians registered with the Austrian Society of Obstetrics and Gynecology between September and October 2020. (3) Results: With a response rate of 24.2% (n = 439), our study shows that diagnosing fetal death was associated with a moderate to high degree of stress, regardless of position (p = 0.949), age (p = 0.110), gender (p = 0.155), and experience (p = 0.150) of physicians. Coping strategies for delivering the news of intrauterine death to affected parents were relying on clinical knowledge and high levels of self-confidence (55.0%; 203/369), support from colleagues (53.9%; 199/369), and debriefing (52.8%; 195/369). In general, facilitators for breaking bad news were more commonly cultivated by female obstetricians [OR 1.267 (95% CI 1.149–1.396); p < 0.001], residents [χ(2)(3;369) = 9.937; p = 0.019], and obstetricians of younger age [41 (34–50) years vs. 45 (36–55) years; p = 0.018]. External facilitators were most frequently mentioned, including professional support, training, professional guidance, time, parents’ leaflets, follow-up consultations, a supporting consultation atmosphere, and preparation before delivering the bad news. Internal facilitators included knowledge, empathy, seeking silence, reflection, privacy, and relief of guilt. (4) Conclusions: Communicating the diagnosis of fetal death evokes moderate to high levels of stress among obstetricians. Resources from both the professional and private environment are required to deal with this professional challenge on a personal level. MDPI 2021-11-17 /pmc/articles/PMC8625483/ /pubmed/34830629 http://dx.doi.org/10.3390/jcm10225347 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Muin, Dana Anais
Erlacher, Janina Sophie
Leutgeb, Stephanie
Felnhofer, Anna
Facilitators and Strategies for Breaking the News of an Intrauterine Death—A Mixed Methods Study among Obstetricians
title Facilitators and Strategies for Breaking the News of an Intrauterine Death—A Mixed Methods Study among Obstetricians
title_full Facilitators and Strategies for Breaking the News of an Intrauterine Death—A Mixed Methods Study among Obstetricians
title_fullStr Facilitators and Strategies for Breaking the News of an Intrauterine Death—A Mixed Methods Study among Obstetricians
title_full_unstemmed Facilitators and Strategies for Breaking the News of an Intrauterine Death—A Mixed Methods Study among Obstetricians
title_short Facilitators and Strategies for Breaking the News of an Intrauterine Death—A Mixed Methods Study among Obstetricians
title_sort facilitators and strategies for breaking the news of an intrauterine death—a mixed methods study among obstetricians
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8625483/
https://www.ncbi.nlm.nih.gov/pubmed/34830629
http://dx.doi.org/10.3390/jcm10225347
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