Significant conversations with parents: a systematic review of interventions to support the communication of bad news in paediatric settings and a qualitative study of parental experiences of receiving a newborn diagnosis of cystic fibrosis

Abstract

Background: Significant conversations with parents are a necessary and important part of healthcare. The delivery of bad or difficult news, such as the diagnosis of a chronic health condition, requires key communication skills. This is especially true for communication between healthcare professionals and parents in paediatric settings. It is important to understand parental experiences of these conversations and what can be done to help support and improve skills in this area.

Method: A systematic review evaluates studies assessing the effectiveness of interventions in improving breaking bad news skills. An empirical study uses Interpretative Phenomenological Analysis of interviews with parents to gain an in-depth understanding of parental experiences of receiving a newborn diagnosis of cystic fibrosis (CF).

Results: The systematic review identified ten quantitative studies assessed to be of either moderate or high quality. Significant improvements in communication skills were found following nine of the ten interventions. These interventions shared some common features. In the empirical study, three superordinate themes emerged following interview analysis: Cognitive and Emotional Experiences; Connection; and Knowledge.

Conclusions: Findings from the review suggest that there are interventions that can improve communication skills in delivering bad news in paediatric settings. Parents in the empirical study clearly recalled the period of receiving a newborn diagnosis of CF as an emotional time. Health professionals’ communication and interpersonal skills seemed to play an important role in providing containment for families. Clinical implications and directions for future research are discussed.