Greiner Andrea L, Conklin Jona
Clinical Assistant Professor, Department of Obstetrics & Gynecology, University of Iowa Carver College of Medicine, Iowa City.
Staff Physician, Perinatal Center of Iowa, Des Moines, IA.
Obstet Gynecol Surv. 2015 Jan;70(1):39-44. doi: 10.1097/OGX.0000000000000149.
Ultrasound is a common procedure performed in pregnancy. Most obstetric patients have an ultrasound between 18 and 20 weeks' gestation. While there is debate regarding the utility of this ultrasound, it has become a routine part of prenatal care. Discovery of a fetal anomaly on ultrasound is most commonly an unexpected, emotionally devastating event for pregnant women. Counseling these women about the ultrasound findings requires empathy and sensitivity. This task falls on the physicians caring for pregnant women: maternal-fetal medicine specialists, radiologists, generalist obstetricians, and family medicine physicians. Their training regarding breaking bad news is varied. Therefore, the purpose of this article is to provide a framework to break bad news of an anomalous fetus for physicians caring for pregnant women using the SPIKES protocol. The SPIKES acronym stands for setting, perception, invitation, knowledge, empathize, summary, and strategy.
超声检查是孕期常见的一项检查。大多数产科患者在妊娠18至20周时会接受超声检查。尽管对于此次超声检查的效用存在争议，但它已成为产前护理的常规组成部分。超声检查发现胎儿异常对孕妇来说通常是一个意外的、情感上极具毁灭性的事件。就超声检查结果为这些女性提供咨询需要同理心和敏感度。这项任务落在照顾孕妇的医生身上：母胎医学专家、放射科医生、普通产科医生和家庭医学医生。他们在传达坏消息方面的培训各不相同。因此，本文的目的是为使用SPIKES协议为照顾孕妇的医生提供一个传达胎儿异常坏消息的框架。SPIKES这个首字母缩略词代表背景、认知、邀请、信息、共情、总结和策略。
