Psychiatry 🧠

Question 1

what are tools of communication classified into?

Answer 1

Question 2

what are bad news?

Answer 2

They are any information, which adversely and seriously affects an individual’s view of his or her future.

Question 3

what are Medical bad news?

Answer 3

Any information related to situations where there is either:
- A feeling of no hope.
- A threat to a person’s mental or physical well-being.
- Risk of upsetting an established lifestyle.
- A message which conveys fewer choices in his or her life.

Question 4

what are the goals of learning how to break bad news?

Answer 4

• Help the patient & his family understand the condition
• Support the patient and his family
• Minimize the risk of overwhelming distress
• Minimize the risk of prolonged denial

Question 5

what do patients want?

Answer 5

• The evidence indicates that patients want additional information regarding their diagnosis.
• Chances of cure.
• The side effects of therapy.
• A realistic estimate of how long they have to live.
• Patients want their doctor to be honest, compassionate, caring, hopeful and informative.
• They want to be told in person, in a private setting, at their pace, with time for discussion

Question 6

How should deliver bad news?

Answer 6

the treating doctor

Question 7

Steps of bad news delivery

Answer 7

• Bad news are delivered using the Robert Buckman’s six steps protocol for breaking bad news:

1. Setting up the interview.
2. Patient perception.
3. Invitation.
4. Knowledge and information.
5. Empathy.
6. Summary and strategy for follow-up

Question 8

Setting up the interview

Answer 8

• Discuss the news in a quiet room free from distractions and interruptions.
• Utilize good communication skills – listening, empathy, eye contact.
• Body language is important – sit down, face the patient.
• Focus on the issue at hand, don’t postpone giving the information.

Question 9

Patient perception

Answer 9

• What does the patient think is the problem?
• What has he/she been told already, and what is the level of understanding?
• Listen to the patient’s vocabulary so that you might incorporate his/her words.
• Avoid technical jargon.

Question 10

Invitation

Answer 10

• Finding out how much the patient wants to know.
• Some patients prefer avoiding information, while others want to know all details.
• Classically speaking: patient should be asked if he likes to share information with family members.
• However, in our culture, family is usually totally involved with the patient and sometimes more than him.

Question 11

Knowledge

Answer 11

Question 12

Empathy

Answer 12

• Patients will have a wide range of emotional reactions as they respond to the bad news delivered to them.
• The emotional response may range from silence to dramatic crying.
• The physician should show an understanding of the patient‘s emotion and demonstrate empathy and respect in the face of a difficult situation.

Question 13

Summary

Answer 13

• To be sure that the message was clear for the patient.
• Planning for the follow-up.
• Offer the available ways for contact in case of raised problems or emergency.

Question 14

what is coming after breaking bad news?

Answer 14

Question 15

Tips in Breaking bad news

Answer 15