C Seifart1, M Hofmann2, T Bär3, J Riera Knorrenschild4, U Seifart5, W Rief2. 1. Institutional Review Board. Electronic address: carola.seifart@staff.uni-marburg.de. 2. Department of Clinical Psychology and Psychotherapy. 3. Institutional Review Board. 4. Department of Internal Medicine, Division of Hematology and Oncology, Philipps-University of Marburg,Marburg. 5. Hospital Sonnenblick, Germany.
Abstract
BACKGROUND: Evaluation of the SPIKES protocol, a recommended guideline for breaking bad news, is sparse, and information about patients' preferences for bad-news delivery in Germany is lacking. Being the first actual-theoretical comparison of a 'breaking bad news' guideline, the present study evaluates the recommended steps of the SPIKES protocol. Moreover, emotional consequences and quality of bad-news delivery are investigated. PATIENTS AND METHODS: A total of 350 cancer patients answered the MABBAN (Marburg Breaking Bad News Scale), a questionnaire representing the six SPIKES subscales, asking for the procedure, perception and satisfaction of the first cancer disclosure and patient's assign to these items. RESULTS: Only 46.2% of the asked cancer patients are completely satisfied with how bad news had been broken to them. The overall quality is significantly related to the emotional state after receiving bad news (r = -0.261, P < 0.001). Patients' preferences differ highly significantly from the way bad news were delivered, and the resulting rang list of patients' preferences indicates that the SPIKES protocol do not fully meet the priorities of cancer patients in Germany. CONCLUSIONS: It could be postulated that the low satisfaction of patients observed in this study reflects the highly significant difference between patients' preferences and bad-news delivery. Therefore, some adjunctions to the SPIKES protocol should be considered, including a frequent reassurance of listeners' understanding, the perpetual possibility to ask question, respect for prearrangement needs and the conception of bad-news delivery in a two-step procedure.
BACKGROUND: Evaluation of the SPIKES protocol, a recommended guideline for breaking bad news, is sparse, and information about patients' preferences for bad-news delivery in Germany is lacking. Being the first actual-theoretical comparison of a 'breaking bad news' guideline, the present study evaluates the recommended steps of the SPIKES protocol. Moreover, emotional consequences and quality of bad-news delivery are investigated. PATIENTS AND METHODS: A total of 350 cancerpatients answered the MABBAN (Marburg Breaking Bad News Scale), a questionnaire representing the six SPIKES subscales, asking for the procedure, perception and satisfaction of the first cancer disclosure and patient's assign to these items. RESULTS: Only 46.2% of the asked cancerpatients are completely satisfied with how bad news had been broken to them. The overall quality is significantly related to the emotional state after receiving bad news (r = -0.261, P < 0.001). Patients' preferences differ highly significantly from the way bad news were delivered, and the resulting rang list of patients' preferences indicates that the SPIKES protocol do not fully meet the priorities of cancerpatients in Germany. CONCLUSIONS: It could be postulated that the low satisfaction of patients observed in this study reflects the highly significant difference between patients' preferences and bad-news delivery. Therefore, some adjunctions to the SPIKES protocol should be considered, including a frequent reassurance of listeners' understanding, the perpetual possibility to ask question, respect for prearrangement needs and the conception of bad-news delivery in a two-step procedure.
Entities:
Keywords:
bad-news delivery; breaking bad news; cancer diagnosis; spikes protocol
Authors: Anthony L Back; Robert M Arnold; Walter F Baile; Kelly A Fryer-Edwards; Stewart C Alexander; Gwyn E Barley; Ted A Gooley; James A Tulsky Journal: Arch Intern Med Date: 2007-03-12
Authors: Paweł Marschollek; Katarzyna Bąkowska; Wojciech Bąkowski; Karol Marschollek; Radosław Tarkowski Journal: J Cancer Educ Date: 2019-04 Impact factor: 2.037
Authors: Fernanda F Oliveira; Glaucia R G Benute; Maria Augusta B Gibelli; Nathalia B Nascimento; Tercilia V A Barbosa; Renata Bolibio; Roberta C A Jesus; Paula V V Gaiolla; Maria Silvia V Setubal; Ana L Gomes; Rossana P Francisco; Lisandra Stein Bernardes Journal: Palliat Med Rep Date: 2020-05-28
Authors: Daniela Leone; Julia Menichetti; Lorenzo Barusi; Elisabetta Chelo; Mauro Costa; Luciana De Lauretis; Anna Pia Ferraretti; Claudia Livi; Arne Luehwink; Giovanna Tomasi; Elena Vegni Journal: Reprod Health Date: 2017-07-20 Impact factor: 3.223