College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland.
Clin Teach. 2024 Apr;21(2):e13671. doi: 10.1111/tct.13671. Epub 2023 Oct 16.
Breaking bad news is one of the hardest tasks performed by doctors. The news can significantly impact on the patient's life; however, the process also generates stress for the doctor. The aim of this study was to explore the lived experiences of breaking bad news for obstetrics trainees in Ireland.
A qualitative study using interpretative phenomenological analysis (IPA) was performed to capture the experience of breaking bad news for the trainees. Semi-structured interviews were conducted with trainees over Zoom. The transcripts were analysed in line with the IPA framework with the assistance of NVivo software.
Seven trainees were interviewed, five at Basic Specialist Training (BST) level and two at Higher Specialist Training (HST) level. Four superordinate themes were identified from the analysis: "the reality of working in obstetrics," "the role of the doctor," "development of communication skills" and "the importance of the patient experience." The trainees described breaking bad news in a variety of clinical contexts. This task could be emotionally draining; however, only two trainees mentioned ways of coping with this. Their formal training was limited with the majority of learning occurring "on the job."
This study provides an insight into factors that influence trainees experiences of breaking bad news. The results complemented existing literature and raised questions about how to better support trainees through increased training and psychological support.
传达坏消息是医生最困难的任务之一。这些消息会对患者的生活产生重大影响，但也会给医生带来压力。本研究旨在探讨爱尔兰妇产科受训者传达坏消息的亲身经历。
采用解释现象学分析（IPA）的定性研究方法，捕捉受训者传达坏消息的体验。通过 Zoom 对受训者进行半结构化访谈。在 NVivo 软件的协助下，根据 IPA 框架对转录本进行分析。
对 7 名受训者进行了访谈，其中 5 名处于基础专科培训（BST）水平，2 名处于高级专科培训（HST）水平。分析确定了四个上位主题：“在妇产科工作的现实”、“医生的角色”、“沟通技巧的发展”和“患者体验的重要性”。受训者描述了在各种临床环境中传达坏消息。这项任务可能会让人情绪疲惫，但只有两名受训者提到了应对这种情况的方法。他们的正式培训有限，大部分学习都是“在职”进行的。
本研究深入了解了影响受训者传达坏消息体验的因素。研究结果补充了现有文献，并提出了如何通过增加培训和心理支持来更好地支持受训者的问题。
