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

2021 ◽  
Vol 10 (22) ◽  
pp. 5347
Author(s):  
Dana Anais Muin ◽  
Janina Sophie Erlacher ◽  
Stephanie Leutgeb ◽  
Anna Felnhofer
Keyword(s):  
Online Survey ◽  
Fetal Death ◽  
Bad News ◽  
Intrauterine Death ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Self Confidence ◽  
Personal Level ◽  
Training Professional ◽  
High Degree

(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 [χ2(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.

scholarly journals An Overview of Teaching Communication of Bad News in Medical School: Should a Lecture be Adequate to Address the Topic?

2016 ◽  
Vol 29 (12) ◽  
pp. 826 ◽  
Author(s):  
Filipe Coutinho ◽  
Anisha Ramessur
Keyword(s):  
Online Survey ◽  
Descriptive Analysis ◽  
Daily Practice ◽  
Bad News ◽  
Breaking Bad News ◽  
Step Method ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Combination Approach ◽  
Delivering Bad News

Introduction: Delivering bad news is very common in medical daily practice. Several studies have shown a lack of effective communication skills amongst medical students, particularly concerning how to deliver bad news. The SPIKES protocol allows communicating bad news in a 6-step method. The aim of this study is to investigate the perspective of students related to this subject.Material and Methods: A 45 minute lecture “Breaking Bad News” was given to 160 students in the fifth and sixth years of the Medicine course, using the SPIKES’ protocol training. After the lecture, an online survey was given to all students, and a cross-sectional and descriptive analysis of data extracted from survey was undertaken.Results: Fifty-four students (21% of overall) answered the online survey. Eighty three percent said that theme should have an important role in their further daily medical practice, and most of students rated the physicians’ role as challenging. Sixty percent of students expressed that communicating bad news was an integral part of the medical course curriculum. Regarding the SPIKES´ protocol, 48% felt that the first step would be the easiest to put in practice, and 40% felt that the fifth step related to “Emotions” would be the most difficult.Discussion: In general, the students would like to gain competencies in breaking bad news using a practical approach Conclusions: Students highly valued theoretical and practical approaches in teaching of communication of bad news. Therefore, we encourage a combination approach in pre-graduate medical education.

scholarly journals Exploring Athletic Trainers' Self-Confidence for Interpreting Results from Concussion Assessments

2019 ◽  
Vol 34 (5) ◽  
pp. 756-756
Author(s):  
N R D’Amico ◽  
T Covassin ◽  
N Murray ◽  
P Schatz ◽  
R J Elbin
Keyword(s):  
Online Survey ◽  
Management Practices ◽  
Athletic Trainers ◽  
Team Approach ◽  
Neurocognitive Testing ◽  
Cross Sectional ◽  
Certified Athletic Trainers ◽  
Concussion Management ◽  
Self Confidence ◽  
National Athletic Trainers Association

Abstract Purpose To explore athletic trainers' self-confidence for interpreting results from concussion assessments. Methods An online survey was administered via the National Athletic Trainers’ Association (NATA) membership listserv to a cross-sectional sample of 10,000 certified athletic trainers (ATCs) employed in high school and collegiate settings. The survey included: 1) ATC demographics (i.e., age, sex, years of experience); 2) ATC concussion management practices (i.e., previous concussion training, continuing education received on concussion, concussion assessments administered); and 3) a 4-point Likert scale (1=no confidence, 4=high confidence) assessing ATC self-confidence for interpreting results from concussion assessments. A total of 725 ATCs completed the survey yielding a response rate of 7.25%; 114 were excluded for missing data and 611 ATCs were included in final analyses. Sample demographics, ATC concussion management practices, and ATC self-confidence scores were examined with demographic statistics (i.e., means, standard deviations, frequencies, percentages) for 16 commonly used concussion assessments. Results The sample of ATCs (mean age 38.97±14.89 years) was predominately female (59.2%) and reported an average of 10.08±7.58 years of clinical experience. Clinical examinations (63.2%) and symptom scales (61.4%) were among the most frequent assessments with high ATC self-confidence for interpretation. Vestibular/oculomotor measures (27.2%) and computerized neurocognitive testing (26.2%) were among the most frequent assessments with low ATC self-confidence for interpretation. Conclusion Low ATC self-confidence scores for interpreting results from vestibular/oculomotor measures and computerized neurocognitive testing highlight the importance of incorporating a multi-disciplinary team approach and including sport neuropsychologists for the proper management of concussion.

scholarly journals Barriers and Motivators of Bicycling by Gender Among Older Adult Bicyclists in the Midwest

2019 ◽  
Vol 47 (1) ◽  
pp. 67-77 ◽  
Author(s):  
Amanda Grimes ◽  
Matthew Chrisman ◽  
Joseph Lightner
Keyword(s):  
Older Adults ◽  
Environmental Factors ◽  
Online Survey ◽  
Ecological Model ◽  
The United States ◽  
Environmental Barriers ◽  
Cross Sectional ◽  
The Social ◽  
Personal Level ◽  
Barriers And Motivators

Introduction. Physical activity (PA), particularly low-impact activities like bicycling, can improve health in older adults. However, bicycling rates are lower in the Midwest than other regions in the United States. Therefore, it is important to identify unique social, personal, and environmental factors that inhibit or promote bicycling, and how these are associated with PA. The influences of these factors were explored using the social ecological model. Method. A cross-sectional online survey was developed using previously validated local and national bicycling questionnaires, then distributed to Midwestern bicyclists 50 years and older. Exploratory factor analysis was conducted to understand the influences of social, personal, and environmental barriers and promoters on bicycling patterns. All models were conducted separately by gender, and accounted for age, race, education, marital status, income, and employment. Results. Social promoters (B = 0.386, p = .002), such as having friends/family that bicycle were associated with greater PA. Personal promoters (B = −0.311, p = .006) such as needing to lose weight were associated with reduced PA. Environmental factors had no associations with PA. However, individual environmental components, such as number of vehicles on the roads, were significantly associated with PA for both males and females. Females reported more barriers than males. The overall model accounted for 16.1% of the total variance in PA levels. Conclusion. Interventions to promote PA via bicycling in older adults should focus on social factors, while also reducing personal-level factors for males. Interventions for females could focus on reducing specific personal, social, and environmental barriers.

scholarly journals Weight expectations, motivations for weight change and perceived factors influencing weight management in young Australian women: a cross-sectional study

2015 ◽  
Vol 19 (2) ◽  
pp. 275-286 ◽  
Author(s):  
Talisha J Holley ◽  
Clare E Collins ◽  
Philip J Morgan ◽  
Robin Callister ◽  
Melinda J Hutchesson
Keyword(s):  
Weight Management ◽  
Weight Change ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Ideal Weight ◽  
Cross Sectional ◽  
Self Confidence ◽  
Factors Influencing ◽  
Current Weight

AbstractObjectiveTo examine young Australian women’s weight expectations, motivations for weight change and perceived factors influencing weight management, and to determine if these factors differ by age, BMI, marital status, education or income.DesignCross-sectional study. An online survey captured respondents’ weight, height, ideal weight, main reasons for wanting to change their weight and challenges to managing their weight.SettingOnline survey in Australia.SubjectsSix hundred and twenty women aged 18–30 years currently living in Australia who completed the survey between 31 July and 30 September 2012.ResultsApproximately half of participants (53·1 %) were a healthy weight, 25·2 % overweight and 19·0 % obese. Women unhappy at their current weight (78·1 %) reported a median ideal weight −12·3 % less than their current weight. The key motivators for weight change were to improve health (24·4 %, ranked 1), feel better in oneself (22·3 %) and improve self-confidence (21·5 %). Lack of motivation, time constraints because of job commitments and cost were the most commonly reported factors influencing weight management. Age, BMI, marital status, education and income were found to influence weight expectations, motivations for weight change and/or factors perceived to influence weight management.ConclusionsThe findings suggest potential implications for weight management interventions and public health messaging targeting young women, to improve long-term health outcomes. Strategies that promote the health benefits of physical activity and healthy eating, feeling better about oneself and improved self-confidence, and address the main factors influencing weight management including lack of motivation, time constraints and cost, may be used to engage this target group.

scholarly journals Breaking bad news of cancer diagnosis - the patient’s perspective

2017 ◽  
Vol 5 (4) ◽  
pp. 1617 ◽  
Author(s):  
Amod S. Dhage ◽  
Anne R. Wilkinson
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Bad News ◽  
Fundamental Aspect ◽  
Junior Resident ◽  
Breaking Bad News ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Patient’S Perspective ◽  
Common Diagnosis

Background: Communication between physicians and patients is a fundamental aspect of cancer care. Bad news could be defined as "any information, which adversely affects an individual's view of his or her future”. The aim of the research study was to explore the patient’s perspective on receiving cancer news and their expectations regarding the same.Methods: A cross-sectional study was performed in our tertiary care teaching hospital. 50 consenting cancer patients from 18 to 60 years of age were interviewed on the basis of a structured, validated questionnaire.Results: On analysis of the 50 patients ‘answers, it was found that 37 were females and 13 were males, the average age being 50.07 years. The common diagnosis in females was breast cancer (20 patients) and in males it was lung cancer (5 patients). All the patients wanted relatives present with them when the bad news was broken to them.  In 66.6% patients, the news was broken by a junior resident, 15% of the doctors didn't greet the patients, 10% of the patients were told the news suddenly, while 99% of the doctors didn’t explain any positive aspects of the disease related to the treatment outcome.Conclusions: This study provides an insight into the expectations of patients from their physicians with regard to the process of breaking bad news.

scholarly journals Breaking bad news of cancer diagnosis – Perception of the cancer patients in a rural community in Malaysia

2014 ◽  
Vol 03 (02) ◽  
pp. 116-121 ◽  
Author(s):  
Mathew Gabriel Bain ◽  
Cheah Whye Lian ◽  
Chang Ching Thon
Keyword(s):  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Current Method ◽  
Bad News ◽  
Breaking Bad News ◽  
Language Management ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Information Giving ◽  
Significant Difference

Abstract Context: Breaking of bad news is an important component in the management of cancer patients. Aims: This study aimed to assess the perceptions of breaking bad news of cancer diagnosis. Settings and Design: It was a cross-sectional study using Breaking Bad News Assessment Schedule (BAS) questionnaire on cancer patients in Serian district. Materials and Methods: Using snowballing sampling method, a total of 134 patients were interviewed face-to-face after the consent was obtained from each of the respondents. Statistical Analysis Used: Data was entered and analyzed using SPSS version 19.0. Results: Majority were comfortable with the current method of breaking bad news. The main aspects found to be the areas of concern were the importance of the usage of body language, management of time and identifying patients′ key area of concerns. There were significant difference between sex and "information giving" (P = 0.028) and "general consideration" (P = 0.016) and also between "the age and setting the scene" (P = 0.042). Significant difference was also found between the types of cancer and "the setting of scene" (P = 0.018), "breaking bad news technique" (P = 0.010), "eliciting concerns" (P = 0.003) and "information giving" (P = 0.004). Conclusion: Good and effective communication skill of breaking bad news is vital in the management of cancer patients. As the incidence of new cases of cancer increase every year, breaking of bad news has become a pertinent to the medical professionals′ role. Specific aspects of communication skills based on local characteristics should be more emphasized in the formulation of training for doctors.

scholarly journals Training and Validation of Incognito Standardized Patients for Assessing Oncology Fellows’ Performance Regarding Breaking Bad News

2021 ◽  
Vol 14 (5) ◽  
Author(s):  
Mandana Shirazi ◽  
Amir Hossein Emami ◽  
Afsaneh Yakhforoshha
Keyword(s):  
Rating Scale ◽  
Reliability And Validity ◽  
Role Playing ◽  
Cross Sectional Study ◽  
Bad News ◽  
Breaking Bad News ◽  
Rater Agreement ◽  
Real Patient ◽  
Cross Sectional ◽  
Breaking Bad

Background: Standardized patient (SP) has been applied to measure learner’s communication challenges such as breaking bad news (BBN). When utilizing SP-based assessment, 2 steps should be considered in SP training; assessing SPs portrayal as the real patient (authenticity) and how SPs checklist fill out reproducibility. Objectives: In this study, we described the process of training authentic and consistent SPs for evaluating oncology fellows’ performance regarding BBN in Iran. Methods: In this cross-sectional study, 8 eligible SPs took part in a 3-day educational meeting. Four different scenarios were developed regarding cancer patients along with corresponding checklists representing common presentations of illness. The accuracy of SPs portrayal was evaluated by experts, using a previously validated rating scale during observation of their role-playing. The reproducibility of SPs’ portraits was measured, using a test-retest approach. The inter-rater agreement of the SPs’ ability to fill out the BBN scale was measured by comparing the correlation between the SPs, who completed the scale, and oncologist faculty members’ judgments, which is considered a gold standard. Results: The findings of this study indicated that the cut-off score for the SPs’ portrayal validity was 95%. The reliability of SPs portrayal was acceptable (r = 0.89). The inter-rater agreement between SPs and experts in filling the BBN scale (k = 0.82), as well as, the consistency of filling the BBN scale between SP groups were highly acceptable (k = 0.86). Conclusions: The present study has demonstrated that if SP is trained appropriately, they shave a high degree of reliability and validity to assess oncology fellows’ performance regarding BBN skills.

scholarly journals Nurses’ Self-Efficacy, Confidence and Interaction with patients with COVID-19: A Cross-Sectional Study

2021 ◽  
pp. 1-16
Author(s):  
Loai. Abu Sharour ◽  
Ayman Bani Salameh ◽  
Khaled Suleiman ◽  
Maha Subih ◽  
Mamdouh El-hneiti ◽  
...  
Keyword(s):  
Organizational Support ◽  
Self Efficacy ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Self Confidence ◽  
Patient Interaction ◽  
Significant Difference ◽  
Cross Sectional Design ◽  
Compensatory Payment

Abstract Objective: the aim was to evaluate nurses’ self-efficacy, confidence and nurse-patient interaction during caring of patients with COVID-19. Methods: A cross-sectional design with online survey was used with a Self-efficacy scale, Self-confidence scale and Caring nurse-patient interaction scale: 23- item Version–Nurse (CNPI-23 N). Results: A sample of 120 nurses participated in the current study. The results showed that the participants had a moderate level of self-efficacy, self-confidence and interaction (M = 28.84 (SD= 7.7), M =47.41 (SD= 9.0) and M= 93.59 (SD=16.3) respectively). Positive relationships were found between nurse’ self-efficacy, self-confidence and nurse-patient interaction (r = 0.81, P < 0.0001 and 0.79, P ＜0.0001 respectively). Significant differences were found in self-efficacy according to years of experience, academic qualifications and position (F = 2.10, P = 0.003, F = 3.60, P = 0.002 and F = 2.60, P =0.007 respectively). Furthermore, the results indicated that there was a significant difference in self-confidence and nurse-patient interaction also. Conclusion: Nurse educators and administrators should develop and implement further strategies such as continuing education and training, compensatory payment, organizational support and availability of protective measures to increase their self-efficacy, self-confidence and interaction with COVID-19 patients.

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