B7.083 Delivering Bad News Flashcards
1
Q
SPIKES protocol
A
setting perspective invitation knowledge exploring strategy
2
Q
setting
A
- plan beforehand, confirm facts
- create conducive environment
- allot adequate time
- determine who the patient would like present
3
Q
perspective
A
what does the patient understand at the time?
- assess ability to comprehend bad news
- establish what the patient knows
- reschedule if unprepared
4
Q
invitation
A
find out how much detail the patient wants
-recognize and support various patient preferences
5
Q
knowledge
A
share the information and then stop
- avoid monologue, promote dialogue
- avoid jargon
- frequent pauses
- check for understanding
- use silence, body language
- don’t minimize severity
6
Q
exploring
A
explore response to the news
- affective response (tears, anger, sadness, love, anxiety, relief)
- cognitive response (denial, blame, guilt, disbelief, fear)
- basic phys response (fight-flight)
7
Q
general communication tips
A
listen quietly and attentively
encourage descriptions of feelings
use nonverbal communication
8
Q
strategy
A
planning and follow-up strategy
- plan for additional tests, referrals
- discuss potential sources of support
- give contact info, set next appt.
- assess safety and support of patient before leaving
9
Q
how to communicate prognosis
A
inquire about reasons for asking avoid precise answers (give averages) limits of prediction -hope for best, plan for worst -better sense over time
