Scholarly record

BREAKING BAD NEWS' - A SHORT REVIEW OF AVAILABLE MODELS

J. Chrastina, J. Mastalir, L. Ludikova

Abstract

The objective of the paper is to present an overview of the findings about applicable models (algorithms) in the area of Breaking Bad News (BBN). The paper presents an overview of selected models with an emphasis on their practical application. The overview was produced by means of an analysis, comparison, discussion and synthesis of relevant findings. The search procedure was performed in line with the specifics of the research strategy using keywords (aimed at methodologies, procedures, and models applied in relation to the BBN process). A well-developed area is the BBN process in (adult) clients with cancer diagnoses. This is a well-designed area in terms of both methodology and feedback with an emphasis on training future doctors (professionals). The oldest and the most frequently used model is the (S)PIKES model (). Other approaches include the BREAKS model, Kaye’s Ten Step Approach, NURSE model, ABCDE model, PEWTER model, etc. Less frequently used models include for example “In Person, In Time”, COMFORT, The 3phase model, SBAR, TALK, ASK–TELL–ASK model, Breaking Bad News Skills Rating Form Checklist (BBN Skills), relevant derived models and some other models. The components of the SPIKES model follow the chronology of the BBN process; other models more or less copy the chronology (including various alternatives adapted to the needs of a specific model). The models use the following components: preparation – setting (up the interview/interaction) – perception (patient’s perception and preparation) – invitation (obtaining the patient’s invitation; information; invitation or information; invitation and information needs) – knowledge (giving knowledge and information to patient; knowledge of the condition) – emotions (addressing the patient’s emotions with empathetic response; empathy; empathy and exploration) – strategy (strategy and summary; summary; summarize or strategize; summary and strategic planning). The process of BBN is a comprehensive and very important communicative competence of each professional. Breaking unfavourable (bad) news is one of the most significant and at the same time difficult forms of clinical practice and requires a set of skills that professionals should learn as routine part of their training. The learning process is an essential component of undergraduate preparation of future professionals.

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