title: Breaking bad news: an interview study of paediatric cardiologists.
abstract: Technical developments in paediatric cardiology over the last few decades have increased expectations on professionals, demanding of them more emotional competence and communicative ability. The aim of this study was to examine the approach of paediatric cardiologists in informing and communicating with the family of the patient.
  
  
  METHODS
  A qualitative interview method was first tested in a pilot study with two paediatric cardiologists. There were nine subsequent semi-structured interviews that were carried out with paediatric cardiologists. A researcher performed all the interviews, which were taped, transcribed, decoded, and analysed.
  
  
  RESULTS
  Among paediatric cardiologists, how to break bad news to the family is an important concern, evident in findings regarding the significance of trust and confidence, the use of different emotional positions, and a common ambition to achieve skills to handle the situation. There is a need for reflection, education, and sharing of experiences. The cardiologists desire further development of teamwork and of skills in medical students and residents for delivering bad news.
  
  
  CONCLUSIONS
  Doctors are expected to cope with the complexities of diagnoses and decisions, while simultaneously being sensitive to the feelings of the parents, aware of their own emotions, and able to keep it all under control in the context of breaking the bad news to the parents and keeping them informed. These conflicting demands create a need to expand the professional role of the doctor by including more training in emotional competence and communicative ability, beginning in medical school and continuing through consultancy.
authors.affiliation: Division of Paediatrics, Department of Clinical Sciences, Umea University, Umea, Sweden.
authors.forename: Anna-Lena
authors.initials: AL
authors.lastname: Birkeland
authors.forename: Lars
authors.initials: L
authors.lastname: Dahlgren
authors.forename: Bruno
authors.initials: B
authors.lastname: Hägglöf
authors.forename: Annika
authors.initials: A
authors.lastname: Rydberg
mesh_terms: D000046:Academic Medical Centers; D001291:Attitude of Health Personnel; D002309:Cardiology; D006330:Heart Defects, Congenital / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D010290:Parents / Q000523:psychology*; D010372:Pediatrics; D010819:Physician's Role / Q000523:psychology*; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology; D010865:Pilot Projects; D011368:Professional-Family Relations; D011379:Prognosis; D013548:Sweden