Birkeland Anna-Lena, Dahlgren Lars, Hägglöf Bruno, Rydberg Annika
Division of Paediatrics, Department of Clinical Sciences, Umea University, Umea, Sweden.
Cardiol Young. 2011 Jun;21(3):286-91. doi: 10.1017/S1047951110001952. Epub 2011 Jan 28.
Technical developments in paediatric cardiology over the last few decades have increased expectations on professionals, demanding of them more emotional competence and communicative ability. The aim of this study was to examine the approach of paediatric cardiologists in informing and communicating with the family of the patient.
A qualitative interview method was first tested in a pilot study with two paediatric cardiologists. There were nine subsequent semi-structured interviews that were carried out with paediatric cardiologists. A researcher performed all the interviews, which were taped, transcribed, decoded, and analysed.
Among paediatric cardiologists, how to break bad news to the family is an important concern, evident in findings regarding the significance of trust and confidence, the use of different emotional positions, and a common ambition to achieve skills to handle the situation. There is a need for reflection, education, and sharing of experiences. The cardiologists desire further development of teamwork and of skills in medical students and residents for delivering bad news.
Doctors are expected to cope with the complexities of diagnoses and decisions, while simultaneously being sensitive to the feelings of the parents, aware of their own emotions, and able to keep it all under control in the context of breaking the bad news to the parents and keeping them informed. These conflicting demands create a need to expand the professional role of the doctor by including more training in emotional competence and communicative ability, beginning in medical school and continuing through consultancy.
在过去几十年里，儿科心脏病学的技术发展提高了人们对专业人员的期望，要求他们具备更强的情感能力和沟通能力。本研究的目的是考察儿科心脏病专家向患者家属通报情况及沟通的方式。
定性访谈方法首先在对两名儿科心脏病专家的预试验中进行了测试。随后对儿科心脏病专家进行了九次半结构化访谈。所有访谈均由一名研究人员进行，访谈进行了录音、转录、解码和分析。
在儿科心脏病专家中，如何向家属传达坏消息是一个重要问题，这在关于信任和信心的重要性、使用不同情感立场以及掌握应对这种情况技能的共同抱负等研究结果中很明显。需要进行反思、教育和经验分享。心脏病专家希望进一步发展团队合作，并提高医学生和住院医生传达坏消息的技能。
医生既要应对诊断和决策的复杂性，同时又要对家长的感受保持敏感，意识到自己的情绪，并在向家长传达坏消息并让他们了解情况的过程中能够控制好一切。这些相互冲突的要求使得有必要扩大医生的专业角色，包括从医学院开始并持续到咨询阶段，增加情感能力和沟通能力方面的培训。
