Abstract
This project is a study of how sonographers break bad news to women during routine prenatal ultrasound scans. The sonographers' position, with respect to breaking bad news, is unique among healthcare professionals. Prenatal scans are designed to detect foetal abnormalities and are offered to all pregnant women as part of a nationwide screening programme in the UK. Ultrasound in pregnancy is, therefore, a medical test, but unlike most medical tests it has become a social ritual in western culture. Many women view the scan as a chance to see and meet their baby for the first time and to take home a picture. They are generally unaware of its screening function, which means that bad news arrives when it is least expected. The news is often divulged in real-time as abnormalities are detected, and this leaves little time for the sonographer to prepare prior to disclosure. What a sonographer does in the few moments following a positive scan result affects how the news is given and ultimately how it is received. A bad experience can leave women suffering long-term psychological effects. This thesis focuses on how sonographers cope in those few moments.The impetus behind this research is paucity of empirical work that has, to date, been carried out from the sonographer's perspective. This means there are few evidence-based guidelines available to assist them in the news-giving process. Current protocols, underpinned by research from the medical profession, suggest that health professionals should prepare to give bad news in advance of meeting the patient. Such advice, however, fails to address the immediate and unexpected nature of bad news in the ultrasound scenario. This project offers an in-depth phenomenological investigation into the experiences of nine sonographers who have been breaking bad news to pregnant women for between eight and twenty five years. Using Heidegger's fundamental ontology as a framework, the five-stage temporal structure of a routine prenatal scan was revealed, offering an insight into how distressing information might be communicated to women in a genuinely empathic manner. This structure suggests that what happens in the moments following the detection of a foetal abnormality depends on a background of phenomena which are revealed only through a sonographer's particular style of scanning and ethical comportment.
| Date of Award | 2 Aug 2012 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Lisa Booth (Supervisor), Marian Nicol (Supervisor) & Ralph Leavey (Supervisor) |
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