Related Experiment Video
Updated: Sep 10, 2025
05:41
Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
Published on: February 9, 2024
730
Designing a SPIKES-based protocol for communicating uncertainty in indeterminate thyroid cytology: a mixed-method
Rossella Melcarne1, Fabrizio Consorti2, Giorgio Grani3
1Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy. rossella.melcarne@uniroma1.it.
Updates in Surgery
|August 27, 2025
Summary
A new communication protocol for indeterminate thyroid cytology significantly improved patient understanding and trust. This structured approach, particularly beneficial for surgical trainees, enhanced patient-centered care and satisfaction with treatment decisions.
Area of Science:
- Endocrine Surgery
- Surgical Communication
- Patient-Centered Care
Background:
- Indeterminate thyroid cytology poses diagnostic challenges, impacting treatment decisions and physician-patient communication.
- Effective communication is vital, especially for surgical trainees managing patient uncertainty and building trust.
- Existing communication strategies may not adequately address the complexities of uncertain thyroid diagnoses.
Purpose of the Study:
- To develop, implement, and pilot a communication protocol for surgeons managing indeterminate thyroid cytology.
- To assess the protocol's impact on patient understanding, emotional response, and trust.
- To document patient reactions to a structured communication approach during surgical consultations.
Main Methods:
- A SPIKES (Setting, Perception, Invitation, Knowledge, Emotion, Strategy) model-based communication protocol was designed.
- Fifty-two patients with indeterminate thyroid cytology participated in a pilot study involving three consultation phases.
- A Decision Aid tool was integrated into the protocol; patient emotional responses and feedback were collected using mixed methods.
Main Results:
- The protocol enhanced patient comprehension and emotional response, with 80% reporting relief after the first consultation.
- By the third encounter, 91% of patients expressed well-being or trust, with serenity and reassurance being common emotions.
- High ratings for communication clarity (96%) and therapeutic decision correctness (88.5%) were reported.
Conclusions:
- A structured SPIKES-based communication protocol effectively addresses patient understanding and trust in managing indeterminate thyroid cytology.
- The protocol supports physicians, particularly trainees, in navigating complex patient interactions in surgical settings.
- Implementation can streamline communication, improve patient-centered care, and enhance satisfaction with treatment outcomes.
