SPIKES Communication Protocol for Delivering Difficult News, Adapted for Clinical Practice
Complete script for communicating serious diagnoses with empathy and structure.
Equip physicians to communicate difficult diagnoses using the SPIKES protocol adapted for clinical practice, respecting patient autonomy and the Code of Medical Ethics.
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Prompt objective
Equip physicians to communicate difficult diagnoses using the SPIKES protocol adapted for clinical practice, respecting patient autonomy and the Code of Medical Ethics.
Real use case
Dr. Juliana, an oncologist at Hospital Santa Maria in Porto Alegre, needs to deliver a stage II breast cancer diagnosis to a 42-year-old patient who is a mother of two children. She wants a script that helps her be empathetic without omitting essential information about treatment.
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Prompt
Develop a complete protocol for delivering difficult news based on the SPIKES method, adapted for clinical practice. The diagnosis to communicate is [DIAGNOSIS] for a [AGE]-year-old patient, [SEX], seen at a [FACILITY_TYPE: private clinic/hospital/primary care clinic]. **S - SETTING (Preparing the Environment):** - Ideal physical setting (private room, no interruptions) - Who should be present (family member? psychologist?) - Time blocked on the schedule - Medical records, test results, and reports organized in advance - Appropriate body language and nonverbal cues **P - PERCEPTION (Assessing the Patient's Understanding):** - 5 model questions to assess what the patient already knows - How to identify level of comprehension and expectations - Transition phrases to the next stage **I - INVITATION (Asking How Much the Patient Wants to Know):** - How to ask how much information the patient wants to receive - Respecting autonomy (Article 34, Code of Medical Ethics) - Cultural adaptations: religious patient, family member who
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- 1Replace the key placeholders first: DIAGNOSIS, AGE, SEX, FACILITY_TYPE: private clinic/hospital/primary care clinic.
- 2Replace any bracketed placeholders like [this] with your own context.
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