Oncologists and Breaking Bad News—From the Informed Patients’ Point of View. The Evaluation of the SPIKES Protocol Implementation

Marschollek, Paweł; Bąkowska, Katarzyna; Bąkowski, Wojciech; Marschollek, Karol; Tarkowski, Radosław

doi:10.1007/s13187-017-1315-3

Cited by 49 publications

(57 citation statements)

References 19 publications

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“…21 An evaluation of the SPIKES implementation found that privacy positively influence patients' rating of their knowledge gained and the experience of the amount of time devoted to it as being sufficient. 39 This is consistent with our interview results that the framing of conversations is of particular importance. As receiving bad news was experienced as traumatic and a trigger for desire to die by some of our interviewees suffering from cancer, it may be appropriate to delay this discussion to follow-up conversations.…”

Section: Framing Timing and Patient-attunement Of Communicationsupporting

confidence: 91%

The Desire to Die in Palliative Care: A sequential mixed methods study to develop a semi-structured clinical aproach

Kremeike

Frerich

Romotzky

et al. 2020

Preprint

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Background: Although desire to die of varying intensity and permanence is frequent in patients receiving palliative care, uncertainty exists concerning appropriate therapeutic responses to it. To support health professionals in dealing with patients´ potential desire to die, a training program and a semi-structured clinical interview approach was developed. This study aimed for a revision of and consensus building on the clinical approach to support proactively addressing desire to die and routine exploration of death and dying distress. Methods: Within a sequential mixed methods design, we invited 16 palliative patients to participate in semi-structured interviews and 377 (inter-)national experts to attend a two-round Delphi process. Interviews were analyzed using qualitative content analysis and an agreement consensus for the Delphi was determined according to predefined criteria. Results: 11 (69%) patients from different settings participated in face-to-face interviews. As key issues for conversations on desire to die they pointed out the relationship between professionals and patients, the setting and support from external experts, if required. A set of 149 (40%) experts (132/89% from Germany, 17/11% from 9 other countries) evaluated ten domains of the semi-structured clinical approach. There was immediate consensus on nine domains concerning conversation design, suggestions for (self-)reflection, and further recommended action. The one domain in which consensus was not achieved until the second round was “proactively addressing desire to die”. Conclusions: We have provided the first semi-structured clinical approach to identify and address desire to die and to respond therapeutically – based on evidence, patients’ views and consensus among professional experts. Trial registration: The study is registered in the German Clinical Trials Register (DRKS00012988; registration date: 27.9.2017) and in the Health Services Research Database (VfD_DEDIPOM_17_003889; registration date: 14.9.2017).

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Section: Framing Timing and Patient-attunement Of Communicationsupporting

confidence: 91%

The Desire to Die in Palliative Care: A sequential mixed methods study to develop a semi-structured clinical aproach

Kremeike

Frerich

Romotzky

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…18 An evaluation of the SPIKES implementation found that privacy positively influence patients' rating of their knowledge gained and the experience of the amount of time devoted to it as being sufficient. 36 This is consistent with our interview results that the framing of conversations is of particular importance. As receiving bad news was experienced as traumatic and a trigger for DD by some of our interviewees suffering from cancer, it may be appropriate to delay this discussion to follow-up conversations.…”

Section: Framing Timing and Patient-attunement Of Communicationsupporting

confidence: 91%

The Desire to Die in Palliative Care: A sequential mixed methods study to develop a semi-structured clinical guideline

Kremeike

Frerich

Romotzky

et al. 2020

Preprint

View full text Add to dashboard Cite

Objective: Although desire to die (DD) of varying intensity and permanence is frequent in patients with advanced cancer and those receiving palliative care, uncertainty exists concerning appropriate therapeutic responses to it. To support health professionals in dealing with patients´ potential DD, a training program and a semi-structured clinical interview guideline was developed. This study aimed for a revision of and consensus building on the clinical guideline to support proactively addressing DD and routine exploration of death and dying distress. Methods: Within a sequential mixed methods design, we invited 16 palliative patients to participate in semi-structured interviews and 377 (inter-)national experts to attend a two-round Delphi process. Interviews were analyzed using qualitative content analysis and an agreement consensus for the Delphi was determined according to predefined criteria. Results : 11 (69%) patients from different settings participated in face-to-face interviews. As key issues for conversations on DD they pointed out the relationship between professionals and patients, the setting and support from external experts, if required. A set of 149 (40%) experts (132/89% from Germany, 17/11% from 9 other countries) evaluated ten domains of the clinical guideline. There was immediate consensus on nine domains concerning conversation design, suggestions for (self-)reflection, and further recommended action. The one domain in which consensus was not achieved until the second round was “proactively addressing DD”. Conclusions : We have provided the first semi-structured clinical guideline to identify and address DD and to respond therapeutically – based on evidence, patients’ views and consensus among (inter-)national professional experts. Trial registration: German Clinical Trials Register (No. DRKS00012988).

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“…"NURSE -Naming, Understanding, Respecting, Supporting, Exploring" for difficult conversation tasks in oncology [38] and "SPIKES -A Six-Step Protocol for Delivering Bad News" for breaking bad news [21]. An evaluation of the SPIKES implementation found that privacy positively influence patients' rating of their knowledge gained and the experience of the amount of time devoted to it as being sufficient [39]. This is consistent with our interview results that the framing of conversations is of particular importance.…”

Section: Framing Timing and Patient-attunement Of Communicationmentioning

confidence: 99%

The desire to die in palliative care: a sequential mixed methods study to develop a semi-structured clinical approach

et al. 2020

View full text Add to dashboard Cite

Background: Although desire to die of varying intensity and permanence is frequent in patients receiving palliative care, uncertainty exists concerning appropriate therapeutic responses to it. To support health professionals in dealing with patients´potential desire to die, a training program and a semi-structured clinical approach was developed. This study aimed for a revision of and consensus building on the clinical approach to support proactively addressing desire to die and routine exploration of death and dying distress. Methods: Within a sequential mixed methods design, we invited 16 palliative patients to participate in semi-structured interviews and 377 (inter-)national experts to attend a two-round Delphi process. Interviews were analyzed using qualitative content analysis and an agreement consensus for the Delphi was determined according to predefined criteria. Results: 11 (69%) patients from different settings participated in face-to-face interviews. As key issues for conversations on desire to die they pointed out the relationship between professionals and patients, the setting and support from external experts, if required. A set of 149 (40%) experts (132/89% from Germany, 17/11% from 9 other countries) evaluated ten domains of the semi-structured clinical approach. There was immediate consensus on nine domains concerning conversation design, suggestions for (self-)reflection, and further recommended action. The one domain in which consensus was not achieved until the second round was "proactively addressing desire to die". Conclusions: We have provided the first semi-structured clinical approach to identify and address desire to die and to respond therapeuticallybased on evidence, patients' views and consensus among professional experts. Trial registration: The study is registered in the German Clinical Trials Register (DRKS00012988; registration date: 27.9.2017) and in the Health Services Research Database (VfD_DEDIPOM_17_003889; registration date: 14.9.2017).

show abstract

Oncologists and Breaking Bad News—From the Informed Patients’ Point of View. The Evaluation of the SPIKES Protocol Implementation

Cited by 49 publications

References 19 publications

The Desire to Die in Palliative Care: A sequential mixed methods study to develop a semi-structured clinical aproach

The Desire to Die in Palliative Care: A sequential mixed methods study to develop a semi-structured clinical aproach

The Desire to Die in Palliative Care: A sequential mixed methods study to develop a semi-structured clinical guideline

The desire to die in palliative care: a sequential mixed methods study to develop a semi-structured clinical approach

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