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Delivering Bad or Life-Altering News.
Franklin J Berkey1, Joseph P Wiedemer1, Nicki D Vithalani1
1Penn State Health Family and Community Medicine Residency at Mount Nittany Medical Center, State College, PA, USA.
American Family Physician
|September 15, 2018
Summary
Delivering difficult medical news requires empathy and clear communication. Physicians should respect patient preferences and utilize structured protocols like SPIKES for effective delivery, reducing patient and physician distress.
Area of Science:
- Medical Communication
- Patient Care
- Physician Well-being
Background:
- Delivering bad news is a challenging but common physician task.
- Bad news can range from chronic disease diagnoses to life-altering illnesses.
- Patient preferences for receiving bad news vary by culture, education, age, and sex.
Purpose of the Study:
- To explore the complexities of delivering bad news to patients.
- To highlight patient preferences and physician challenges in this process.
- To introduce structured protocols for effective bad news delivery.
Main Methods:
- Review of literature on physician-patient communication regarding serious news.
- Analysis of patient preferences for receiving difficult information.
- Examination of physician emotional responses and coping strategies.
- Introduction of the SPIKES protocol as a guiding framework.
Main Results:
- Patients prefer in-person delivery with full attention, clear language, and time for questions.
- Physicians experience significant stress, fearing emotional reactions and personal emotional expression.
- Withholding information or excessive optimism can confuse patients.
- Structured protocols like SPIKES can guide physicians in delivering bad news effectively.
Conclusions:
- Skillful delivery of bad news is crucial for patient comfort and understanding.
- Respecting patient preferences and utilizing communication frameworks enhances the process.
- Addressing physician stress is important for effective patient care during difficult conversations.
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