Breaking bad news – informing parents on suspicion of prenatally detected Down syndrome in obstetric institutions: Hungarian experience

Abstract

For health care professionals, breaking bad news postnatally to parents in case of suspected Down syndrome is a difficult task to perform. The aim of the study was to investigate the Hungarian practice as well as deficiencies from the perspective of the physicians providing first information in order to improve the current system. For better interpretability of the results, we compared the practice of providing first information in Hungary (74% national coverage) with 23 obstetric institutions in Germany. In Germany, communication training has already been incorporated into the curriculum of medical and health care higher education. It was found that 95% of the Hungarian and German institutions have no protocol for providing information. In Germany, the professionals get significantly more communication training (p=0.06) and more contact with civil organizations (p<0.01). In Hungary information stressing the negative aspects of the situation is more often given (p=0.024), while less consolation (p=0.017) and printed brochures are provided for parents (p<0.01). Hungarian physicians feel more often (p=0.022) they are not capable of helping the parents. The Hungarian practice of providing information needs improvement. The possible tools for improvement are the introduction of communication training in undergraduate and postgraduate education of health professionals as well as working on and elaborating policies concerning the breaking of bad news.