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Tips for Breaking bad news A Critical clinical skill Prof.Mervat Atfy Mohamed

Tips for Breaking bad news A Critical clinical skill Prof.Mervat Atfy Mohamed. Zagagazig university hospital. After this session, you will: *Recognize challenge to share bad news effectively

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Tips for Breaking bad news A Critical clinical skill Prof.Mervat Atfy Mohamed

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  1. Tips for Breaking bad newsA Critical clinical skillProf.MervatAtfy Mohamed Zagagazig university hospital

  2. After this session, you will: *Recognize challenge to share bad news effectively *Be able to describe an effectively six steps process to share bad news-SPIKES .Application to the Patient with Cancer Be committed to improving your * skills in breaking bad news to patient Learning objectives: www.themegallery.com

  3. Any news that seriously and negatively alters the patient s view to her/his future What is Bad news? www.themegallery.com

  4. *Help the patient and family understand the condition *Support patient and Family *Minimize risk of overwhelming distress Goals www.themegallery.com

  5. :*The physician perspective high degree of difficult + physician anxiety = High risk of performing poorly. When physicians are uncomfortable in giving bad news they mayavoid discussing distressing information, such as a poor prognosis Why it is critical skill? www.themegallery.com

  6. Why it is critical skill? www.themegallery.com

  7. For themselves *More time to talk and show feelings From Doctors More information, caring. Confidence ,hopefulness, Familiar face What do patients want? www.themegallery.com

  8. Six step Protocol For breaking bad Application to the Patient with Cancer news: www.themegallery.com

  9. STEP 1: S :Setting up The interview *Private setting, sitting down *No telephone, turn off mobile ,no interruptions *Ensure adequate time *Review the condition ,lab, basic prognosis and treatment before visit *Hopeful tone www.themegallery.com

  10. STEP 2: P—ASSESSING THE PATIENT'S Perception "before you tell, ask." *Assess the gap between what the patient knows and diagnosis. * What have been told about what are going on? *What is your understanding why the CT scan was ordered? Mervat atfy mohamed

  11. STEP 2: P—ASSESSING THE PATIENT'S Perception Based on thisinformation you can correct misinformation to patient www.themegallery.com

  12. STEP 3: I—OBTAINING THE PATIENT'S Invitation While a majority of patients express a desire for full informationabout their diagnosis, prognosis, and details of their illness,some patients do not www.themegallery.com

  13. STEP 4: K—GIVING KNOWLEDGE AND INFORMATION TO THE PATIENT Warning the patient that bad news is coming may lessen the shockthat can follow the disclosure of bad news and may facilitateinformation processing. Examples of phrases that can beused include, "Unfortunately I've got some bad news to tellyou“ or "I'm sorry to tell you that...". www.themegallery.com

  14. STEP 4: K—GIVING KNOWLEDGE AND INFORMATION TO THE PATIENT Avoid excessive bluntness (e.g., "You have very bad cancerand unless you get treatment immediately you are going to die.")as it is likely to leave the patient isolated and later angry,with a tendency to blame the messenger of the bad news Try to use nontechnical words such as "spread" insteadof "metastasized" and "sample of tissue" instead of "biopsy." www.themegallery.com

  15. Balanced truth and Hope :skillful use of indirect language when the prognosisis poor, avoid using phrases such as "There is nothing morewe can do for you." This attitude is inconsistent with the factthat patients often have other important therapeutic goals suchas good pain control and symptom relief As ( it is look like) not (you have….. (There are tumours in the liver) not (you have tumor in your liver www.themegallery.com

  16. STEP 5: E—ADDRESSING THE PATIENT'S EMOTIONS WITH EMPATHIC RESPONSES * Observe for and allow all emotional reaction *Use touch Name the feelings….. I know this is upsetting ……..it would be for any oneUnderstanding www.themegallery.com

  17. Respond to EmpathicallyEmotions Respecting…….you are asking all the Right questions www.themegallery.com

  18. STEP 6: S—Summary and strategy for follow up www.themegallery.com

  19. Six step Protocol For breaking bad Application to the Patient with Cancer news: www.themegallery.com

  20. At the end The task of breaking bad news is testing ground for entire range of our professional skills. if we do it badly patients and family will never forgive us, if we do it well patients and their family never forget us www.themegallery.com

  21. Your Business Company slogan in here Thank You ! www.themegallery.com

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