SPIKES-D: a proposal to adapt the SPIKES protocol to deliver the diagnosis of dementia

Peixoto, Vanessa Giffoni de Medeiros Nunes Pinheiro; Diniz, Rosiane Viana Zuza; Godeiro-Júnior, Clécio

doi:10.1590/1980-57642020dn14-040001

Cited by 6 publications

(2 citation statements)

References 28 publications

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“…This 6-step format ( s etting–arrange appropriate location, p erception–check with the patient knows, i nformation–ask what the patient wants to know, k nowledge–share information in small portions, e mpathy–expect emotion and respond empathically, s trategy/ s ummary–recap important points and outline next steps) covers many of the best practices suggested for dementia disclosure ( Table 2 ). Perhaps unsurprisingly, researchers recently suggested adapting the protocol to create SPIKES-dementia (SPIKES-D) approach [ 53 ]. This could be used to facilitate either formal teaching regarding dementia disclosure or self-education, particularly as the SPIKES approach is familiar to many clinicians.…”

Section: Discussionmentioning

confidence: 99%

Clinician approaches to communicating a dementia diagnosis: An interview study

et al. 2022

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Background Individuals with cognitive impairment and their families place a high value on receiving a dementia diagnosis, but clinician approaches vary. There is a need for research investigating experiences of giving and receiving dementia diagnoses. The current study aimed to investigate clinician approaches to giving dementia diagnoses as part of a larger study investigating patient, caregiver, and clinician experiences during the diagnosis encounter. Method Investigators conducted telephone interviews with Florida-based clinicians who give dementia diagnoses either rarely or commonly. Interviews employed a semi-structured interview guide querying communication practices used by clinicians when giving dementia diagnoses and how clinicians learned to give dementia diagnoses. Investigators used a descriptive qualitative design to conduct a thematic analysis of data. Results Fifteen Florida-based clinicians participated, representing diverse backgrounds related to gender, race/ethnicity, specialty, and practice setting. Participants reported using patient- and family-centered communication practices including checking patient understanding, communicating empathically, and involving family members. Some clinicians explicitly asked patients and/or family members about their preferences regarding diagnosis disclosure; many clinicians tailored their disclosure based on patient and family characteristics or reactions. Some clinicians reported using specific diagnoses, while others used general terms such as “memory disorder.” Clinicians reported positively framing information, including instilling hope, focusing on healthy behaviors, and discussing symptom management. Finally, clinicians provided patient/family education and arranged follow up. Clinicians reported learning approaches to dementia diagnosis disclosure through formal training and self-education. Conclusions Diverse Florida-based clinicians described dementia disclosure practices largely consistent with published guidance, but clinicians varied on approaches relating to soliciting patient disclosure preferences and terminology used. Clinicians caring for diverse populations described that cultural background affects the disclosure process, but more research is needed regarding this finding and best practices for individuals from different backgrounds.

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Section: Discussionmentioning

confidence: 99%

Clinician approaches to communicating a dementia diagnosis: An interview study

et al. 2022

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“…El protocolo SPIKES (Buckman, 1992) es un método utilizado en medicina clínica para dar malas noticias a pacientes y familiares. Ha sido adaptado por Peixoto et al, para revelar el diagnóstico de EA (SPIKES-D) (Peixoto, 2020). Esta herramienta incluye factores tales como la empatía, el reconocimiento y la validación de los sentimientos, el suministro de información sobre la intervención y el tratamiento y la garantía de que el paciente comprenda aquello que se le trasmite.…”

Section: Discussionunclassified

Comunicación del diagnóstico de enfermedad de Alzheimer: reflexiones bioéticas

Labos¹,

Fustinoni

2022

Vertex Rev Arg Psiquiatr

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Al comunicar al paciente el diagnóstico de enfermedad de Alzheimer, pueden originarse situaciones no acordes con la necesaria conducta ética profesional. Presentamos dos casos en los que, al actuarse con imprudencia, no se respetó el requisito de no maleficencia, En ambos casos la revelación diagnóstica empeoró la situación previa a la consulta, provocando en el paciente y su familia decisiones y consecuencias desafortunadas. El uso abrupto y cortante del término “Alzheimer”, junto a la información insuficiente sobre las características de la afección, parece haber sido el factor principal de un impacto emotivo negativo, mostrando una actitud profesional dueña de un saber “absoluto” e inapelable, en un vínculo sin equidad. El acto de comunicar un diagnóstico debe ajustarse al criterio de prudencia, y no solamente al de veracidad o exactitud, evitando por sobre todas las cosas provocar un daño mayor al ya causado por la enfermedad.

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