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General Strategies – Evidence Reviewed
General Strategies 2018-01-30T16:37:10+08:00
  • Setting
    • Private room to speak to patient and / or family
    • Involvement of significant others
    • Have both parties seated, at eye level
    • Look calm, maintain eye contact
    • Listening mode: do not interrupt the patient or talk over the patient
      • Silent pauses to allow patient to talk
    • Repetition as a means to acknowledge what the patient is saying
    • Availability – silence phones etc.
  • Perception: “before you tell, ask”
    • Allows patient’s expectations to be understood – gives an estimation of the “impact” of the bad news, and an opportunity to impart knowledge before breaking bad news or dealing with anger
    • Ask patient what they know of the situation
      • What did you think was going on when you felt the lump?
      • What have you been told about all this so far?
      • Are you worried that this may be something serious?
    • Take note of the language the patient is using, and use a similar vocabulary
    • Do not confront denial head on initially
  • Invitation
    • Check that a patient really wants to know what is going on before delivering news
      • Are you the kind of person who prefers to know all the details of what’s going on?
  • Knowledge or sign posting
    • Give patients a warning of what is about to come, so they have more time to mentally prepare
      • Sir, unfortunately the news I have is concerning. Would you like me to proceed at this stage?
      • Ma’am, I’m so sorry, but I have troubling news.
    • Avoid jargon
    • Give information in small chunks
      • Check understanding at frequent intervals
      • Go over information again if news is not acknowledged
      • Always check after each “chunk” that the patient is ok to proceed with the discussion
    • Tailor the rate of the discussion – slow down if the patient is having difficulty processing
  • Empathy: responding to patient’s emotions
    • Do not downplay the severity of the information, or hold information back unless specifically asked
      • This may just serve to discredit in the future, or shake trust
    • Acknowledge patient’s emotions when they arise, and address them
      • Listen for and identify the emotion. If unsure:
        • How does this make you feel?
        • What do you make of what I have just told you?
      • Identify the source of the emotion – e.g. the bad news, delayed diagnosis etc.
      • Show the patient that the connection between the above two has been made
        • I can see that this news is terribly distressing for you
        • Hearing the results of the bone scan is a major shock for you
      • Normalize the emotions
    • Such responses validate a patient’s emotions, and reduce isolation
  • Strategy and summary
    • Summarise the information given to the patient in the discussion
    • Check for any concerns or questions not addressed
    • Give the patient a plan of action
    • Give the patient a safety net and assurance of follow-up

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This Is A Custom Widget

This Sliding Bar can be switched on or off in theme options, and can take any widget you throw at it or even fill it with your custom HTML Code. Its perfect for grabbing the attention of your viewers. Choose between 1, 2, 3 or 4 columns, set the background color, widget divider color, activate transparency, a top border or fully disable it on desktop and mobile.