SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer

2000/08/01 by Walter F. Baile, Robert Buckman, Renato Lenzi +3 · 1 voice · 14 citations
Health Professions · Medicine · #Palliative Care and End-of-Life Issues #Patient Dignity and Privacy #Patient-Provider Communication in Healthcare

paper · pdf · doi:10.1634/theoncologist.5-4-302

openalex publication_date 2000/08/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01

Abstract

We describe a protocol for disclosing unfavorable information-"breaking bad news"-to cancer patients about their illness. Straightforward and practical, the protocol meets the requirements defined by published research on this topic. The protocol (SPIKES) consists of six steps. The goal is to enable the clinician to fulfill the four most important objectives of the interview disclosing bad news: gathering information from the patient, transmitting the medical information, providing support to the patient, and eliciting the patient's collaboration in developing a strategy or treatment plan for the future. Oncologists, oncology trainees, and medical students who have been taught the protocol have reported increased confidence in their ability to disclose unfavorable medical information to patients. Directions for continuing assessment of the protocol are suggested.

Citations

• Opening the Black Box: How Do Physicians Communicate about Advance Directives?
• Breaking bad news: why is it still so difficult?

Cited by

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• Core Competencies in Palliative Care for Surgeons: Interpersonal and Communication Skills
• A randomized controlled trial evaluating stress arousal reappraisal and worked example effects on psychophysiological responses during breaking bad news
• The clinical practice guideline for the management of amyotrophic lateral sclerosis in Japan—update 2023
• Challenges experienced by those with polycystic ovary syndrome in healthcare interactions: a qualitative evidence synthesis
• Communication and neurology - bad news and how to break them
• Palliative care
• Conhecimento médico sobre comunicação de más notícias: estudo tipo survey
• How to communicate with families living in complete isolation
• Exploring the psychophysiological predictors of performance under stress: insights from a machine learning approach
• Trait-agreeableness influences individual reactions to a physician’s affiliative behavior in a simulated bad news delivery
• How GPs communicate the urgent suspected cancer referral pathway to patients: a qualitative study of GP–patient consultations
• La comunicazione della diagnosi di malattia di alzheimer: aspetti clinici ed etico-giuridici
• Breaking bad news: Comparing the perception of the role, barriers and experiences of neonatal intensive care and well‐baby nursery nurses

Discussions

• ¡Muy buena pregunta, gracias! El problema que veo con esto es que la teoría se suele quedar ahí. Lo suyo sería que se hicieran formaciones específicas para trabajarlo de forma práctica. De base ti [bsky, 0 points, 1 comments]