Temrinal Illness And Breaking Bad News Flashcards Preview

ESA 3 - HPHD > Temrinal Illness And Breaking Bad News > Flashcards

Flashcards in Temrinal Illness And Breaking Bad News Deck (25)
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1

What are the 'three main patterns of dying'?

Gradual death

Catastrophic death

Premature death

2

Define 'gradual death'

Death with a slow decline in ability and health

3

Define 'catastrophic death'

Death through sudden and unexpected events

4

Define 'premature death'

Death in children and young adults through accidents or illness

5

Outline the 5 stages of grief

Denial

Anger

Bargaining

Depression

Acceptance

6

Define 'denial' as a stage of grief

Where the person uses denial to adjust to the fact they are dying without being emotionally overwhelmed.

7

Define 'anger' as a stage of grief

Anger stems from a frustration at dying and is often directed at those closest to the person. Will often ask questions such as 'why me?'.

8

Define 'bargaining' as a stage of grief

People often try to make a deal with God or medical professionals so they can live, promising good behaviour in return for their life.

9

Define 'depression' as a stage of grief

Often occurs when the person realises that there is nothing that can be done. Often seen as 'anticipatory grief' where the person mourns their own death.

10

Define 'acceptance' as a stage of grief

Where the person accepts their death with calmness and peace.

11

What does denial allow for in the early stages of receiving bad news?

Allows a way to cope with overwhelming information and emotions.

12

What is it important to do when a patient is exhibiting denial?

Check that they understand, and how much information they want to know.

Respect their desire 'not to know'

13

How can help be given to patients in the denial stage of grief?

Offer written information for them to look over with their family

Check and review them over time - when they are ready

14

Why is it important to deliver bad news appropriately?

It can have an impact on:

- doctor-patient relationship

- emotional well-being of the patient

- adjustment to and ability to cope with the illness, for patients and their relatives

15

Is 'bad news' always bad news?

No

16

Why can bad news sometimes be seen in better light?

Some (but certainly not all) patients may be relieved to have a diagnosis, may feel they can now have at least a chance at treatment or to be relieved of pain, and they may feel like a burden has been lifted from the carer

17

On what factors should you tailor your approach to the breaking of bad news?

-Their needs, wishes and priorities

-Their level of knowledge about their condition

-The nature of their condition

-The complexity of the treatment

-The nature and level of risk associated with the treatment

18

What model is recommended to break bad news?

SPIKES

19

What does SPIKES stand for?

Setting - and listening skills
Patient's perception
Invitation from patient
Knowledge
Empathy
Strategy and summary

20

Outline the first 'S' in the SPIKES model

-Break news face-to-face

-Ensure privacy, no interruptions and adequate time

-Find out who the patient wants present

-Introduce yourself and colleagues

21

Outline the 'P' in the SPIKES model

Find out the patient's perception of their condition, 'ask before you tell'

22

Outline the 'I' in the SPIKES model

Wait for or look for an invitation from the patient to provide them with information

23

Outline the 'K' in the SPIKES model

-Give a warning shot:
"I'm very sorry to have to tell you this"

-Direct them to the diagnosis in small chunks

Avoid jargon, and align language used with the patients

24

Outline the 'E' in the SPIKES model

Provide an empathetic response to the patient. Ask how they feel about the information and listen to their concerns.

25

Outline the second 'S' in the SPIKES model

Summarise the main discussion topics

Discuss strategy for the future with the patient

Close the conversation with the option for questions