Table 3

Behaviours identified from all three sources

• Organise a private, quiet, comfortable location

• Schedule ample time

• Establish a trusting & supportive relationship with the patient

• Identify the most appropriate approach to disclosure based on knowledge of the patient and family

• Identify informal support available for the patient after disclosure

• Identify formal support available for the patient after disclosure

• Prepare the patient in earlier consultations

• Break the news over a series of contacts

• Discuss ahead of time how much information the patient would like about diagnosis and prognosis

• Respect the patient's right (not) to know

• Negotiate the presence of a relative with the patient

• Establish the patient's perceptions about their symptoms

• Give information step by step according to the patient's ability to cope with it

• Use terminology carefully as a way of getting information across without telling patients what they don't want to hear

• Check understanding frequently

• Be direct in disclosing the diagnosis

• Explicitly name the illness

• Avoid the use of technical terminology or medical jargon

• Discuss how the person's current problems may progress in the light of the probable diagnosis

• Provide an opportunity for the patient to absorb and emotionally process the information

• Create time and space for the individual to explore what the diagnosis means to them

• Provide an opportunity to discuss the diagnosis again, answer questions & clarify matters

• Repeat or reinforce information as required

• Document the information given and to whom

• Identify further medical and social care pathways

• Ensure information is consistent across professionals

• Provide (written) information on practical & emotional support available from health & social care services

• Provide (written) information on practical & emotional support available from voluntary organisations

• Identify the (practical) implications of the diagnosis

• Disclose all the treatment options (including no treatment)

• Do not impart too much information in one session

Lecouturier et al. BMC Health Services Research 2008 8:95   doi:10.1186/1472-6963-8-95

Open Data