A 65-year-old woman recently underwent a core needle biopsy for a suspicious pulmonary mass. The pathology report has returned, confirming extensive-stage small cell lung cancer with hepatic metastases. The physician is preparing to discuss these results with the patient in the outpatient oncology clinic. According to the SPIKES protocol—the validated framework for delivering serious medical news—arrange the following physician actions and statements in the correct chronological order.
- 1Arrange for a private, uninterrupted environment and sit down at eye level with the patient.
- 2Assess the patient's current understanding by asking, 'What have you been told so far about why we ordered the biopsy?'
- 3Obtain permission by asking, 'How much detail would you like me to go into regarding your test results?'
- 4Deliver the news clearly by stating, 'I am sorry to tell you that the biopsy shows lung cancer that has spread to your liver.'
- 5Respond to the patient's reaction by stating, 'I can see this is incredibly difficult news to hear.'
- 6Formulate a follow-up plan and summarize the immediate next steps for symptom management and oncology consultation.
Cevap
The correct chronological sequence for delivering serious news is: Setting up the interview, assessing Perception, obtaining Invitation, giving Knowledge, addressing Emotions, and finally formulating a Strategy and Summary.
The correct sequence strictly follows the validated SPIKES six-step protocol for delivering serious news. This framework ensures that the physician first establishes a supportive environment, assesses what the patient already knows, respects their information preferences, delivers the news clearly, responds empathetically to their emotional reaction, and finally establishes a clear plan for the future.
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The SPIKES Protocol for Delivering Serious Medical News
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