Current Issue
Issues
Aim & Scope
Open Access
Indexing
Why publish with us
Contact
Editorial Board
Manuscript Types
Manuscript Formatting
How to submit
For readers
For librarians
Authorship & COI
Principles of Transparency Checklist
Publication Ethics and Publication Malpractice Statement
CrossMark
Data Policies
RESEARCH PAPER
Ανακοίνωση δυσάρεστων ειδήσεων στη Μονάδα Εντατικής Νοσηλείας Νεογνών: Μια αφηγηματική ανασκόπηση
1
Μονάδα Εντατικής Νοσηλείας Νεογνών, Ιδιωτική Γενική, Μαιευτική-Γυναικολογική & Παιδιατρική Κλινική «Μητέρα», Αθήνα, Ελλάδα
2
Τμήμα Μαιευτικής, Πανεπιστήμιο Δυτικής Αττικής, Αθήνα, Ελλάδα
3
Β’ Μαιευτική και Γυναικολογική Κλινική, Αρεταίειο Νοσοκομείο, Ιατρική Σχολή, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών, Αθήνα, Ελλάδα
Submission date: 2024-12-09
Final revision date: 2025-02-10
Acceptance date: 2025-02-16
Publication date: 2025-03-28
Corresponding author
Δήμητρα Μεταλλινού
Τμήμα Μαιευτικής, Πανεπιστήμιο Δυτικής Αττικής, Αγ. Σπυρίδωνος 28, 12243, Αιγάλεω, Ελλάδα
Τμήμα Μαιευτικής, Πανεπιστήμιο Δυτικής Αττικής, Αγ. Σπυρίδωνος 28, 12243, Αιγάλεω, Ελλάδα
ΕΛΕΥΘΩ 2025;24(1):3
KEYWORDS
Breaking bad newsNeonatal Intensive Care UnitsCommunication protocolsParental emotional well-beingHealthcare professional trainingPsychological impacts
TOPICS
ABSTRACT
Introduction:
Announcing unpleasant news to parents whose neonates are in Neonatal Intensive Care Units (NICUs) is a critical issue as it affects parents’ emotional well-being, and their bond with their neonate and healthcare professionals, too. This narrative review aims to explore the needs and challenges that are associated with breaking bad news, proposing practical solutions and strategies to enhance family support and improve their experience during the neonate’s stay in the NICU.
Methods:
TThis narrative review is a result of numerous studies — observational, experimental, systematic reviews, and meta-analyses — published between 2010 and 2024, in electronic databases including PubMed and Google Scholar, using MeSH terms. Data screening and extraction were conducted independently by two reviewers, with disagreements resolved through discussion with a third reviewer. No formal quality assessment was performed.
Results:
The data analysis focused on three main themes: the implementation of communication protocols, the psychological and emotional impact of breaking bad news, and the need for ongoing training of healthcare professionals. Findings highlight the importance of structured protocols, such as “SPIKES”, “ABCDE Mnemonic”, “NEO-SPEAK Framework”, and “BREAKS Protocol”, to enhance empathy, transparency, and communication effectiveness. Psychological impacts on parents include increased anxiety, post-traumatic stress, and grief, while healthcare professionals experience stress and burnout. The need for training is imperative, emphasizing experiential workshops and structured mentoring.
Conclusions:
Breaking bad news requires a combination of empathy and professionalism. Training healthcare professionals and developing communication guidelines are essential to improving care in NICUs, strengthening family support, and enhancing staff well-being.
Announcing unpleasant news to parents whose neonates are in Neonatal Intensive Care Units (NICUs) is a critical issue as it affects parents’ emotional well-being, and their bond with their neonate and healthcare professionals, too. This narrative review aims to explore the needs and challenges that are associated with breaking bad news, proposing practical solutions and strategies to enhance family support and improve their experience during the neonate’s stay in the NICU.
Methods:
TThis narrative review is a result of numerous studies — observational, experimental, systematic reviews, and meta-analyses — published between 2010 and 2024, in electronic databases including PubMed and Google Scholar, using MeSH terms. Data screening and extraction were conducted independently by two reviewers, with disagreements resolved through discussion with a third reviewer. No formal quality assessment was performed.
Results:
The data analysis focused on three main themes: the implementation of communication protocols, the psychological and emotional impact of breaking bad news, and the need for ongoing training of healthcare professionals. Findings highlight the importance of structured protocols, such as “SPIKES”, “ABCDE Mnemonic”, “NEO-SPEAK Framework”, and “BREAKS Protocol”, to enhance empathy, transparency, and communication effectiveness. Psychological impacts on parents include increased anxiety, post-traumatic stress, and grief, while healthcare professionals experience stress and burnout. The need for training is imperative, emphasizing experiential workshops and structured mentoring.
Conclusions:
Breaking bad news requires a combination of empathy and professionalism. Training healthcare professionals and developing communication guidelines are essential to improving care in NICUs, strengthening family support, and enhancing staff well-being.
CONFLICT OF INTEREST
The authors have completed and submitted the ICMJE Form for
Disclosure of Potential Conflicts of Interest and none was reported.
REFERENCES (25)
1.
Abbaszadeh A, Ehsani SR, Begjani J, et al. Nurses' perspectives on breaking bad news to patients and their families: a qualitative content analysis. J Med Ethics Hist Med. 2014;7:18.
2.
Al-Harrasi S, Sabei SA, Omari OA, Abrawi UA. Nurses' Job Burnout and Resilience in Neonatal Intensive Care Units. J Perinat Neonatal Nurs. 2024;38(2):201-211. doi:10.1097/JPN.0000000000000817
3.
Altimier L, Phillips R. The Neonatal Integrative Developmental Care Model: Advanced Clinical Applications of the Seven Core Measures for Neuroprotective Family-centered Developmental Care. Newborn Infant Nurs Rev. 2016;16(4):230-244. doi:10.1053/j.nainr.2016.09.030
4.
Babaie M, Nourian M, Atashzadeh-Shoorideh F, Manoochehri H, Nasiri M. An exploration of patient safety culture in NICUs: a convergent parallel mixed-method study. BMC Health Serv Res. 2024;24(1):1348. doi:10.1186/s12913-024-11644-2
5.
Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000;5(4):302-311. doi:10.1634/theoncologist.5-4-302
6.
Bry A, Wigert H, Bry K. Need and benefit of communication training for NICU nurses. PEC Innov. 2023;2:100137. doi:10.1016/j.pecinn.2023.100137
7.
Buljac-Samardzic M, Doekhie KD, van Wijngaarden JDH. Interventions to improve team effectiveness within health care: a systematic review of the past decade. Hum Resour Health. 2020;18(1):2. doi:10.1186/s12960-019-0411-3
8.
Busse M, Stromgren K, Thorngate L, Thomas KA. Parents' responses to stress in the neonatal intensive care unit. Crit Care Nurse. 2013;33(4):52-60. doi:10.4037/ccn2013715
9.
Harisson C, Canadian Paediatric Society, Bioethics Committee. Treatment decisions regarding infants, children and adolescents. Paediatr Child Health. 2004;9(2):99-103. doi:10.1093/pch/9.2.99
10.
De Bernardo G, Svelto M, Giordano M, Sordino D, Riccitelli M. Supporting parents in taking care of their infants admitted to a neonatal intensive care unit: a prospective cohort pilot study. Ital J Pediatr. 2017;43(1):36. doi:10.1186/s13052-017-0352-1
11.
Ionio C, Mascheroni E, Colombo C, Castoldi F, Lista G. Stress and feelings in mothers and fathers in NICU: identifying risk factors for early interventions. Prim Health Care Res Dev. 2019;20:e81. doi:10.1017/S1463423619000021
12.
Kasat K, Stoffels G, Ellington M. Improving communication with parents: the Neonatal Intensive Care Unit Empathy Workshop. J Perinatol. 2020;40(9):1423-1432. doi:10.1038/s41372-020-0742-x
13.
Labrie NHM, van Veenendaal NR, Ludolph RA, Ket JCF, van der Schoor SRD, van Kempen AAMW. Effects of parent-provider communication during infant hospitalization in the NICU on parents: A systematic review with meta-synthesis and narrative synthesis. Patient Educ Couns. 2021;104(7):1526-1552. doi:10.1016/j.pec.2021.04.023
14.
Letcher DC, Roth SJ, Varenhorst LJ. Simulation-Based Learning: Improving Knowledge and Clinical Judgment Within the NICU. Clin Simul Nurs. 2017;13(6):284-290. doi:10.1016/j.ecns.2017.03.001
15.
Loutfy A, Zoromba MA, Mohamed MA, et al. Family-centred care as a mediator in the relationship between parental nurse support and parental stress in neonatal intensive care units. BMC Nurs. 2024;23(1):572. doi:10.1186/s12912-024-02258-4
16.
Machado GCC, de Carvalho Furtado MC, Baptista Oliveira NT, de Jesus Santos JM, Lima M, Leite AM. How is the communication of bad news being performed in Neonatal Intensive Care Units and how to improve it: A Scoping Review. J Neonatal Nurs. 2020;26(5):252-258. doi:10.1016/j.jnn.2020.01.014
17.
Malouf R, Harrison S, Burton HAL, et al. Prevalence of anxiety and post-traumatic stress (PTS) among the parents of babies admitted to neonatal units: A systematic review and meta-analysis. EClinicalMedicine. 2021;43:101233. doi:10.1016/j.eclinm.2021.101233
18.
Marino LV, Collaḉo N, Coyne S, et al. The Development of a Communication Tool to Aid Parent-Centered Communication between Parents and Healthcare Professionals: A Quality Improvement Project. Healthcare (Basel). 2023;11(20):2706. doi:10.3390/healthcare11202706
19.
Metallinou D, Bardo S, Kitsonidou I, Sotiropoulou N. Attitudes and Experiences Towards Death of Healthcare Professionals Working in Neonatal Intensive Care Units. Omega (Westport). 2023;88(2):570-590. doi:10.1177/00302228211048667
20.
Nnate DA, Nashwan AJ. Emotional Intelligence and Delivering Bad News in Professional Nursing Practice. Cureus. 2023;15(6):e40353. doi:10.7759/cureus.40353
21.
Rabow MW, McPhee SJ. Beyond breaking bad news: how to help patients who suffer. West J Med. 1999;171(4):260-263.
22.
Seifart C, Falch M, Wege M, Maier RF, Pedrosa Carrasco AJ. NEO-SPEAK: A conceptual framework that underpins breaking bad news in neonatology. Front Pediatr. 2022;10:1044210. doi:10.3389/fped.2022.1044210
23.
Sullivan A, Cummings C. Historical Perspectives: Shared Decision Making in the NICU. Neoreviews. 2020;21(4):e217-e225. doi:10.1542/neo.21-4-e217
24.
Tzamakos E, Metallinou D, Sarantaki A, Tigka M, Lykeridou A, Nanou C. The Relationship between Attitudes toward Death and Emotional Intelligence, Personality, Resilience, and Justice Beliefs: A Cross-Sectional Study of Midwives in Greece. Eur J Investig Health Psychol Educ. 2024;14(4):1101-1113. doi:10.3390/ejihpe14040072
25.
Yu CC, Tan L, LE MK, et al. The development of empathy in the healthcare setting: a qualitative approach. BMC Med Educ. 2022;22(1):245. doi:10.1186/s12909-022-03312-y
| ISSN: | 1106-6822 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
