Session 10 - Breaking Bad. News.

Question 1

Define bad news

Answer 1

Any information that drastically alters a patient’s view of their future for the worse.

Question 2

Why is it important to tell patients bad news? Give 3 reasons

Answer 2

• To maintain trust
• To reduce uncertainty
• To prevent unrealistic expectation
• To allow appropriate adjustment
• To promote open communication
• To decrease patient uncertainty, anxiety, distress, and dissatisfaction

Question 3

What are the implications if bad news is not delivered well?

Answer 3

• Impacts doctor-patient relationship
• Impacts emotional well being of patient e.g. distress and depression
• Impacts on adjustment to and ability to cope with the illness

Question 4

What blocking behaviours do HCPs employ in breaking bad news? Give 3

Answer 4

• Changing the subject
• Giving information/advice before concerns have been elicited
• Focusing only on physical aspects

Question 5

Describe each step in the SPIKES model

Answer 5

S – Setting and listening skills (break news face to face)

P – Patient’s perception (what does patient know already?)

I – Invitation from patient (how much does patient want to know)

K – Knowledge (Use clear language)

E – Empathy

S – Strategy and summary (be optimistic but not reassuring)