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:	Dana Anais Muin, Janina Sophie Erlacher, Stephanie Leutgeb, Anna Felnhofer
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	stillbirth fetal death intrauterine death breaking bad news resilience stress Medicine R
Acceso en línea:	https://doaj.org/article/b4258911e5554496b12f48d8c5ee52ff
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spelling	oai:doaj.org-article:b4258911e5554496b12f48d8c5ee52ff2021-11-25T18:01:57ZFacilitators and Strategies for Breaking the News of an Intrauterine Death—A Mixed Methods Study among Obstetricians10.3390/jcm102253472077-0383https://doaj.org/article/b4258911e5554496b12f48d8c5ee52ff2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5347https://doaj.org/toc/2077-0383(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% (<i>n</i> = 439), our study shows that diagnosing fetal death was associated with a moderate to high degree of stress, regardless of position (<i>p</i> = 0.949), age (<i>p</i> = 0.110), gender (<i>p</i> = 0.155), and experience (<i>p</i> = 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); <i>p</i> < 0.001], residents [χ<sup>2</sup>(3;369) = 9.937; <i>p</i> = 0.019], and obstetricians of younger age [41 (34–50) years vs. 45 (36–55) years; <i>p</i> = 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.Dana Anais MuinJanina Sophie ErlacherStephanie LeutgebAnna FelnhoferMDPI AGarticlestillbirthfetal deathintrauterine deathbreaking bad newsresiliencestressMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5347, p 5347 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	stillbirth fetal death intrauterine death breaking bad news resilience stress Medicine R
spellingShingle	stillbirth fetal death intrauterine death breaking bad news resilience stress Medicine R Dana Anais Muin Janina Sophie Erlacher Stephanie Leutgeb Anna Felnhofer Facilitators and Strategies for Breaking the News of an Intrauterine Death—A Mixed Methods Study among Obstetricians
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% (<i>n</i> = 439), our study shows that diagnosing fetal death was associated with a moderate to high degree of stress, regardless of position (<i>p</i> = 0.949), age (<i>p</i> = 0.110), gender (<i>p</i> = 0.155), and experience (<i>p</i> = 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); <i>p</i> < 0.001], residents [χ<sup>2</sup>(3;369) = 9.937; <i>p</i> = 0.019], and obstetricians of younger age [41 (34–50) years vs. 45 (36–55) years; <i>p</i> = 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.
format	article
author	Dana Anais Muin Janina Sophie Erlacher Stephanie Leutgeb Anna Felnhofer
author_facet	Dana Anais Muin Janina Sophie Erlacher Stephanie Leutgeb Anna Felnhofer
author_sort	Dana Anais Muin
title	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_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_sort	facilitators and strategies for breaking the news of an intrauterine death—a mixed methods study among obstetricians
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/b4258911e5554496b12f48d8c5ee52ff
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Facilitators and Strategies for Breaking the News of an Intrauterine Death—A Mixed Methods Study among Obstetricians

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