HealthPsych Session 10 Flashcards Preview

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Flashcards in HealthPsych Session 10 Deck (18)
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1
Q

When can presumed ‘bad news’ be perceived better than expected?

A
Relief about having disagnosis
Able to be treated
Carer feels burden lifted
Age
Familial obligations
2
Q

What should be used to tailor info sharing with a pt?

A

Pt needs, wishes and priorities
Pt knowledge and understanding of condition, prognosis and Tx options
Nature of condition
Complexity of Tx
Nature and level of risk assoc w/investigation or Tx

3
Q

What MUST you give information that pts want/need on?

A

Diagnosis and prognosis
Uncertainties and further investigations
Options for Tx and management inc. refusal
Purpose and process of investigation or Tx
Potential benefits, risks and burdens for each option and if these differ among providers

4
Q

Why is it important to break bad news well?

A
Maintain trust
Decrease uncertainty
Prevent unrealistic expectations
Allow appropriate adjustment
Promote open communication
Majority of pts want to know diagnosis, progress and Tx
Drs find it easier to Tx informed pts
5
Q

Why is concealment of information in terminal illness permissible in some cultures?

A

Disclosure to pt is seen as harmful/cruel/dangerous so family is informed instead

6
Q

What makes breaking bad news difficult?

A
Fear of pt's reaction
Desire to protect pt
Fear of blame
Lack of confidence in communication
Sense of failure
Embarrassment
Reminder of own mortality
Time constraints
7
Q

What are the outcomes of poor delivery of bad news?

A

Poorer dr-pt relationship
Worse emotional well-being
Worse adjustment and ability to cope for pts and relatives

8
Q

What should be documented when breaking bad news to a pt?

A

Consultation inc. what the pt was told to avoid repetition/assumptions by future HCP

9
Q

What model is used for breaking bad news?

A

SPIKES

10
Q

What does SPIKES stand for?

A
Setting and listening skills
Patient's perception
Invitation from pt to give information
Knowledge
Empathy
Strategy and summary
11
Q

Describe the Setting and listening skills part of the SPIKES model.

A

Face to face consultation
Ensure privacy and no interruptions
Ascertain before consultation who pt wants present
Introduce everyone present and keep number to a minimum
Sit down, eyes level, stay calm, no physical barriers, offer tissues
Use silence and repetition as much as possible

12
Q

What is considered in the Patient’s perception aspect of the SPIKES model?

A

What do they know already?

Are they prepared/do they know what investigations they have had were for?

13
Q

Describe the Invitiation from patient aspect of the SPIKES model.

A

Don’t assume pt wants to know everything
Allow for denial
Offer further discussion/things to take away and read

14
Q

What happens during the knowledge stage of the SPIKES model?

A

Warning shot for preparation –> small chunk of info –> timid to consider and ask Qs –> check understanding +/- pt recap –> repeat with another small chunk of info

15
Q

How should knowledge be communicated when breaking bad news?

A

Using clear and simple explanations
Avodpiding medical language and euphemisms
Incorporate key terms used by pts

16
Q

Describe the empathy aspect of the SPIKES model.

A

Acknowledge connection between news and emotion and validate

Listen to pt concerns and address where possible

17
Q

What should happen in the strategy and summary part of the SPIKES model?

A

Recap main topics and understanding
Agree on next step
Offer help if distressed

18
Q

What is bad news?

A

Any info that drastically alters a pt’s view of their future for the worse
Situations where there is a feeling of no hope/threat to mental or physical well being
Risk of upsetting established lifestyle
Decreased choices in life