title: Breaking bad news, the diagnosis of cystic fibrosis in childhood.
abstract: BACKGROUND
  The day parents are told their child has cystic fibrosis (CF) is imprinted in their memory. Parents often show strong emotions (e.g. shock, anxiety); they need to cope with bad news and restructure their lives taking into account CF.
  
  
  OBJECTIVE
  The aims of this study are (1) to explore how parents recall circumstances of the CF diagnosis and the information they received and (2) to investigate their current coping styles.
  
  
  METHODS
  Parents (n=38) of 20 children (diagnosed during the past 5 years) were interviewed using a semi-structured interview. Coping was assessed using the Utrecht Coping List. The association between coping and time since diagnosis/severity of illness was investigated.
  
  
  RESULTS
  Fifteen parents first heard the term 'CF' from their local pediatrician or GP. All were informed in detail by the CF specialist. All parents recalled specifics about the information, the attitude of the doctor, their thoughts and emotions. Most parents were satisfied with the content and manner in which they had received information. Nineteen appreciated the doctor showing some emotions during the talks. One couple criticized the doctor for not showing emotions. Parents reported higher use (than normative scores) of the active coping style 'social support seeking' and the accommodative coping styles 'palliative reaction pattern' and 'comforting cognitions'. Perception of severity of illness was associated with higher scores on palliative coping.
  
  
  CONCLUSIONS
  This study shows the importance of physicians and CF teams to tailor the way of providing bad news to parents' needs and preferences. It is important to help and encourage parents to use active or accommodative coping strategies. The diagnosis is the starting point of a long-term relationship. 'Doing things well from the start' helps families to learn to live with CF and treatment.
authors.affiliation: Cystic Fibrosis Centre, Pediatric Pulmonology, University Hospital Gasthuisberg Leuven, Belgium. Electronic address: trudy.havermans@uzleuven.be.
authors.forename: Trudy
authors.initials: T
authors.lastname: Havermans
authors.affiliation: Psychology Department, Katholieke Universteit Leuven, Belgium.
authors.forename: Jessica
authors.initials: J
authors.lastname: Tack
authors.affiliation: Cystic Fibrosis Centre, Pediatric Pulmonology, University Hospital Gasthuisberg Leuven, Belgium.
authors.forename: Anneke
authors.initials: A
authors.lastname: Vertommen
authors.affiliation: Cystic Fibrosis Centre, Pediatric Pulmonology, University Hospital Gasthuisberg Leuven, Belgium.
authors.forename: Marijke
authors.initials: M
authors.lastname: Proesmans
authors.affiliation: Cystic Fibrosis Centre, Pediatric Pulmonology, University Hospital Gasthuisberg Leuven, Belgium.
authors.forename: Kris
authors.initials: K
authors.lastname: de Boeck
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000175:diagnosis* / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents / Q000523:psychology*; D014342:Truth Disclosure; D055815:Young Adult
keywords: Bad news; Communication; Coping; Cystic fibrosis diagnosis; Parents