Patients’ Perceptions of Receiving a Diagnosis of a Hematological Malignancy, Following the SPIKES Protocol
Objective: Sharing devastating news with patients is
often considered the most difficult task of doctors. This study aimed
to explore patients’ perceptions of receiving bad news including
which features improve the experience and which areas need refining. Methods: A questionnaire was written based on the steps of the
SPIKES model for breaking bad new. 20 patients receiving treatment
for a hematological malignancy completed the questionnaire. Results: Overall, the results are promising as most patients praised
their consultation. ‘Poor’ was more commonly rated by women and
participants aged 45-64. The main differences between the ‘excellent’
and ‘poor’ consultations include the doctor’s sensitivity and checking
the patients’ understanding. Only 35% of patients were asked their
existing knowledge and 85% of consultations failed to discuss the
impact of the diagnosis on daily life. Conclusion: This study agreed with the consensus of existing
literature. The commended aspects include consultation set-up and
information given. Areas patients felt needed improvement include
doctors determining the patient’s existing knowledge and checking
new information has been understood. Doctors should also explore
how the diagnosis will affect the patient’s life. With a poorer
prognosis, doctors should work on conveying appropriate hope. The
study was limited by a small sample size and potential recall bias.
[1] R. Breaking bad news: why is it still so difficult? BMJ 1984;
288(6430):1597-9.
[2] Seifart C, Bär T, Hofmann M, Rief W, Riera Knorrenschild J, Seifart U.
Breaking bad news-what patients want and what they get: Evaluating the
SPIKES protocol in Germany. Annals of Oncology 2014;25(3):707-11.
[3] Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP.
SPIKES - A six-step protocol for delivering bad news: Application to
the patient with cancer. Oncologist 2000;5(4):302-11.
[4] Tate P. Special situation and patients. In: The Doctor's Communication
Handbook Radcliffe Publishing, 2010.
http://books.google.co.uk/books?id=pbY3AuXtnUQC.
[5] Faulkner A. Breaking bad news. In: When the News is Bad: A Guide for
Health Professionals Stanley Thornes, 1998.
http://books.google.co.uk/books?id=vymXTSk6sVcC.
[6] Martins RG, Carvalho IP. Breaking bad news: Patients' preferences and
health locus of control. Patient Education and Counseling 2013;
92(1):67-73.
[7] Narayanan V, Bista B, Koshy C. 'Breaks' Protocol for Breaking Bad
News. Indian Journal Of Palliative Care 2010;16(2):61-5.
[8] Arnautska E. Breaking Bad News. Trakia Journal of Sciences
2010;8:491-2.
[9] Brown VA, Furber L, Thomas AL, Parker PA. Patient preferences for
the delivery of bad news - the experience of a UK Cancer Centre.
European Journal of Cancer Care 2011;20(1):56-61.
[10] Longmore JM, Wilkinson IB, Davidson EH. Oncology and palliative
care. In: Oxford Handbook of Clinical Medicine. Oxford University
Press, 2010:523.
http://books.google.co.uk/books?id=vmmncQAACAAJ.
[11] Paul CL, Clinton-McHarg T, Sanson-Fisher RW, Douglas H, Webb G.
Are we there yet? The state of the evidence base for guidelines on
breaking bad news to cancer patients. European Journal of Cancer
2009;45(17):2960-6.
[12] Fallowfield LJ, V. Communicating sad, bad, and difficult news in
medicine. Lancet 2004;363(9405):312-9.
[13] Dias L, Chabner BA, Lynch TJ, Penson RT. Breaking bad news: A
patient's perspective. Oncologist 2003;8(6):587-96.
[1] R. Breaking bad news: why is it still so difficult? BMJ 1984;
288(6430):1597-9.
[2] Seifart C, Bär T, Hofmann M, Rief W, Riera Knorrenschild J, Seifart U.
Breaking bad news-what patients want and what they get: Evaluating the
SPIKES protocol in Germany. Annals of Oncology 2014;25(3):707-11.
[3] Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP.
SPIKES - A six-step protocol for delivering bad news: Application to
the patient with cancer. Oncologist 2000;5(4):302-11.
[4] Tate P. Special situation and patients. In: The Doctor's Communication
Handbook Radcliffe Publishing, 2010.
http://books.google.co.uk/books?id=pbY3AuXtnUQC.
[5] Faulkner A. Breaking bad news. In: When the News is Bad: A Guide for
Health Professionals Stanley Thornes, 1998.
http://books.google.co.uk/books?id=vymXTSk6sVcC.
[6] Martins RG, Carvalho IP. Breaking bad news: Patients' preferences and
health locus of control. Patient Education and Counseling 2013;
92(1):67-73.
[7] Narayanan V, Bista B, Koshy C. 'Breaks' Protocol for Breaking Bad
News. Indian Journal Of Palliative Care 2010;16(2):61-5.
[8] Arnautska E. Breaking Bad News. Trakia Journal of Sciences
2010;8:491-2.
[9] Brown VA, Furber L, Thomas AL, Parker PA. Patient preferences for
the delivery of bad news - the experience of a UK Cancer Centre.
European Journal of Cancer Care 2011;20(1):56-61.
[10] Longmore JM, Wilkinson IB, Davidson EH. Oncology and palliative
care. In: Oxford Handbook of Clinical Medicine. Oxford University
Press, 2010:523.
http://books.google.co.uk/books?id=vmmncQAACAAJ.
[11] Paul CL, Clinton-McHarg T, Sanson-Fisher RW, Douglas H, Webb G.
Are we there yet? The state of the evidence base for guidelines on
breaking bad news to cancer patients. European Journal of Cancer
2009;45(17):2960-6.
[12] Fallowfield LJ, V. Communicating sad, bad, and difficult news in
medicine. Lancet 2004;363(9405):312-9.
[13] Dias L, Chabner BA, Lynch TJ, Penson RT. Breaking bad news: A
patient's perspective. Oncologist 2003;8(6):587-96.
@article{"International Journal of Medical, Medicine and Health Sciences:70872", author = "L. Dixon and D. Gavani", title = "Patients’ Perceptions of Receiving a Diagnosis of a Hematological Malignancy, Following the SPIKES Protocol", abstract = "Objective: Sharing devastating news with patients is
often considered the most difficult task of doctors. This study aimed
to explore patients’ perceptions of receiving bad news including
which features improve the experience and which areas need refining. Methods: A questionnaire was written based on the steps of the
SPIKES model for breaking bad new. 20 patients receiving treatment
for a hematological malignancy completed the questionnaire. Results: Overall, the results are promising as most patients praised
their consultation. ‘Poor’ was more commonly rated by women and
participants aged 45-64. The main differences between the ‘excellent’
and ‘poor’ consultations include the doctor’s sensitivity and checking
the patients’ understanding. Only 35% of patients were asked their
existing knowledge and 85% of consultations failed to discuss the
impact of the diagnosis on daily life. Conclusion: This study agreed with the consensus of existing
literature. The commended aspects include consultation set-up and
information given. Areas patients felt needed improvement include
doctors determining the patient’s existing knowledge and checking
new information has been understood. Doctors should also explore
how the diagnosis will affect the patient’s life. With a poorer
prognosis, doctors should work on conveying appropriate hope. The
study was limited by a small sample size and potential recall bias.", keywords = "Communication, diagnosis, hematology, patients.", volume = "9", number = "9", pages = "703-5", }