Breaking Bad News Flashcards

1
Q

What model can be used to help facilitate breaking bad news?

A

SPIKES

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2
Q

How should you start a consultation in which you would be breaking bad news?

A
  • Introduction
  • Identity check
  • Consent
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3
Q

How can active listening skills be displayed in a consultation?

A
  • Appropriate eye contact
  • Open body language
  • Nodding
  • Avoid interrupting
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4
Q

What is the first ‘S’ in SPIKES?

A

Setting

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5
Q

What is the ideal setting for breaking bad news?

A

A comfortable, quiet and private room

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6
Q

Where should breaking bad news never be done?

A

Standing in a corridor

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7
Q

What are the bare minimum essentials for breaking bad news?

A
  • Everyone sitting
  • Some privacy
  • Tissues
  • No interruptions
  • Essential information
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8
Q

Who else may be in the room when breaking bad news?

A
  • Other HCP
  • Relatives
  • No one
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9
Q

Who decides who else may be in the room when breaking bad news?

A

The patient

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10
Q

What does the ‘P’ stand for in SPIKES?

A

Perception

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11
Q

What does ‘perception’ involve in breaking bad news?

A
  • Establishing preceding events

- Establish patient’s knowledge

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12
Q

What does ‘I’ stand for in the SPIKES model?

A

Invitation

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13
Q

What does ‘invitation’ imply when breaking bad news?

A

Check that the patient wants to receive the news today

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14
Q

What does the ‘K’ in SPIKES stand for?

A

Knowledge

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15
Q

What does ‘knowledge’ mean when breaking bad news?

A

Delivering the information in sizeable chunks and checking regularly for understanding

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16
Q

What should be given before imparting the information on the patient when breaking bad news?

A

Give a warning shot

17
Q

What is an appropriate warning shot when breaking bad news?

A

‘Unfortunately the results were not what we were hoping for…’

18
Q

What sort of language should be used when breaking bad news?

A

Simple language

19
Q

After giving the diagnosis, when should you continue speaking?

A

Usually after the patient speaks, or when you feel enough time has passed that they are able to process more information

20
Q

What should you do if a patient has a strong emotional reaction to the news?

A

Allow them time and space to do so offering tissues where appropriate

21
Q

What does ‘E’ stand for in SPIKES?

A

Empathy and emotions

22
Q

What does ‘empathy and emotions’ involve when breaking bad news?

A

Empathise with their emotions, acknowledge their feelings and be honest with any information given following the bad news

23
Q

What does ‘S’ stand for in SPIKES?

A

Strategy and summary

24
Q

What does ‘strategy and summary’ involve when breaking bad news?

A

Making plans for the future and summarising the consultation to check patient understanding

25
What should a future strategy involve when breaking bad news?
- Plans for follow-up - Plans for further investigations - Plans for management
26
Do all future strategies have to be planned on the day?
No, allow patients time if they need it to process the information
27
How should breaking bad news be summarised?
- Check understanding - Repeat any information necessary - Answer any concerns - Offer assistance and written information to answer future questions