L’annonce de mauvaises nouvelles : émotions et feed-back dans la formation des médecins

Analysis of communication and logistic processes in neonatal intensive care unit

BACKGROUND

In neonatology, parents play a central role as guarantors of the new-born's autonomy. Notifying parents about their infant's status in neonatal critical care is an integral part of the care. However, conveying this information can be very difficult for physicians and the neonatal medical team. The objective of this work is to assess the dimensions and dynamic processes of critical care communications in neonatal intensive care in order to enhance the development of theoretical and applied knowledge of these discussions.

METHODS

This qualitative, descriptive study was conducted on critical care new-borns less than 28 days-old who were hospitalized in a neonatal intensive care unit. Verbatim communications with the parents were recorded using a dictaphone.

RESULTS

The verbatim information had five themes: (a) critical care, (b) establishing the doctor-patient relationship, (c) assistance in decision making, (d) Socio-affective and (e) socio-symbolic dimensions. Our recordings underscored both the necessity of communication skills and the obligation to communicate effectively. Analysis of the dynamics of the communication process, according to the categories of delivering difficult information, showed few significant differences.

CONCLUSION

Physician training needs to include how to effectively communicate to parents to optimize their participation and cooperation in managing their care.

Le travail de l’interprète en consultation d’annonce : une étude de cas

Annoncer le diagnostic de cancer impose un cadre précis, a fortiori lorsqu’il s’agit de patients migrants non francophones. Dans ce contexte, la présence d’un interprète soulève des questions spécifiques : quelle est sa place dans le dispositif d’annonce ? Comment sa présence influence-t-elle la communication médecin–patient ? Traduire le diagnostic revient à l’annoncer à un patient qui l’entend pour la première fois ; il en résulte des effets émotionnels chez l’interprète, peu étudiés dans la littérature. À partir d’une double expérience de psychologue et d’interprète, les auteurs de l’article analysent la singularité de ces effets lors de l’annonce du cancer à une femme d’origine arménienne.