Patients’ Perceptions of Receiving a Diagnosis of a Hematological Malignancy, Following the SPIKES Protocol
Objective: Sharing devastating news with patients is
often considered the most difficult task of doctors. This study aimed
to explore patients’ perceptions of receiving bad news including
which features improve the experience and which areas need refining. Methods: A questionnaire was written based on the steps of the
SPIKES model for breaking bad new. 20 patients receiving treatment
for a hematological malignancy completed the questionnaire. Results: Overall, the results are promising as most patients praised
their consultation. ‘Poor’ was more commonly rated by women and
participants aged 45-64. The main differences between the ‘excellent’
and ‘poor’ consultations include the doctor’s sensitivity and checking
the patients’ understanding. Only 35% of patients were asked their
existing knowledge and 85% of consultations failed to discuss the
impact of the diagnosis on daily life. Conclusion: This study agreed with the consensus of existing
literature. The commended aspects include consultation set-up and
information given. Areas patients felt needed improvement include
doctors determining the patient’s existing knowledge and checking
new information has been understood. Doctors should also explore
how the diagnosis will affect the patient’s life. With a poorer
prognosis, doctors should work on conveying appropriate hope. The
study was limited by a small sample size and potential recall bias.
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