Breaking bad news (hereditary condition)

1. Preparation - Ensure privacy and adequate time - Patient comfort - Be prepared, e.g. make sure you have the results or patient record 2. Set the scene - Summarise what has happened to date and check with patient - What is the patient thinking or feeling - Negotiate agenda 3. Sharing information - Assess patient understanding - Give a warning shot - Provide information simply and honestly - Avoid jargon - Give information in small parts (use pen and paper if necessary) - Relate your explanation to the patients framework 4. Be sensitive to the patient - Encourage patient to express their feelings - Look for non verbal cues - Keep pausing for questions - Allow time for the patient to stop listening - Acknowledge and respond to patient feelings - Check patient understanding 5. Planning and support - Give a broad timeframe for what lies ahead - Assist in prioritising patient concerns - Plan what happens next, discuss options - Work together 6. Follow up and closing - Summarize and check with patient - Arrange review - Provide information on support services - Offer assistance to tell others - Make written material available 7. Document in patient record

1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Ensure privary and adequate time Assess patient understanding Provide information simply and honestly Encourage patients to express their feelings Give a broad timeframe Arrange review Discuss options Offer assistance to tell others Provide information on support services Document information given