Clinical relationship and psychological experience of hospitalization in "high-risk" pregnancy

Objective: To explore, in a systemic view, the reciprocal perceived relationship between hospitalized "high-risk" pregnant women with uncertain fetal prognosis and the multidisciplinary prenatal care team, by the use of specifically developed questionnaires. Study design: A pilot study in a high-risk pregnancy department. We enrolled 52 pregnant hospitalized women and 17 clinical operators and we interviewed them by the use of open-ended and close-ended question questionnaires. Results: We described patients' perception of doctors and staff communication, patients' feelings and emotions relating to "high-risk" pregnancy and hospitalization, operators' emotions, perceived facilitating factors, difficulties and resources. In a "high-risk" pregnancy condition, some difficulties in the relationship between hospitalized women and health operators occur. For inpatients the emotional difficulties were mostly connected to the pathologic situation and the contingent loneliness. Although the majority of women said that they understood staff communication and that they established a basic trust towards the entire clinical staff, there was a request for greater outspokenness. For clinical operators the relational and communication difficulties specifically concerned the overall management of the relationship with the patients studied. In particular, they perceived themselves to be called to a greater clearness and clinical reliability. Conclusions: Overcoming the dyadic model of the doctor-patient relationship (in a systemic view) by incorporating clinical operators' and inpatients' points of view, seems a useful tool to highlight critical and facilitating factors about the relationship and communication in "high-risk" conditions. Condensation Overcoming the dyadic vision of the doctor-patient relationship, by crossing clinical operator's and inpatient's points of view, seems a useful tool to highlight critical and facilitating factors about the relationship and communication in "high-risk" pregnancy conditions. (C) 2010 Elsevier Ireland Ltd. All rights reserved.