communication

Question 1

SPIKES
S - setting

Answer 1

• quiet private space with no interuptions
• greet patient by name and introduce self

Question 2

SPIKES
P - perception

Answer 2

assess what patient knows and what patient expects
- ‘are you aware of what may be wrong’
- apologise for errors/inconveniences if appropriate

Question 3

SPIKES
- information/ invitation

Answer 3

allow patient to ask questions
- ‘ do you want to ask me any questions’

Question 4

SPIKES
K - knowledge

Answer 4

• give warning ‘wish i had better news’
• no jargon
• explain clearly, use aids e.g radiograph if appropriate
• explain reasons
• explain treatment options

Question 5

SPIKES
E - empathy

Answer 5

acknowledge patients emotions - verbal and non verbal
‘ i understand this is not what you wanted to hear’

Question 6

SPIKES
S - summary

Answer 6

provide strategic plan
allow questions
ensure pt understands
offer phone number for further questions

Question 7

AVDR

Answer 7

acronym for domestic abuse communication
Ask - ask about abuse in private setting ‘ i noticed some bruises is everything okay?’
Validate - show you are concerned ‘concerned for your safety’
Document - detailed documentation of discussion and injuries
Refer(signpost) - signpost to help services (scottish domestic abuse helpline)

Question 8

3As of smoking cessation

Answer 8

Ask - about smoking habits - how many, how long, what age start
Ask again - interest in quitting, tried before
(can also offer advice on dental/ general health implications)
Act - referral to specialist/ pharmacist services