Kaye

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Kayes Model

• Breaking Bad News

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Idea

• This is the best know set of suggestions for
  breaking bad news.
• Not based on rigorous research.
• Stood the test of time.
• Most popular set of rules amongst teachers and
  practitioners.
• Not to be followed in a slavish manner.

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Key

• The key point of the model is that it interlaces
  facts with questions about feelings.
• Getting the balance right.

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Suitability

• Not just cancer.
• Any serious illness.
• Patients and doctors differ in their perceptions
  of seriousness.
• They also differ amongst themselves!

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Ten Steps

• A logical sequence.
• Remember you have time not to be completed in
  one breakneck go!

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1 Preparation

• Know all the facts.
• Ensure privacy.
• Find out who the patient wants present.
• Introduce yourself.

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2 What Does the Patient Know?

• Open ended questions.
• Statements may make the best questions.
• How did it all start?

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3 Is More Information Wanted?

• Not forced on them.
• Would you like me to explain a bit more?

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4 Give a Warning Shot

• Not straight out with it!
• Im afraid it looks rather serious

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5 Allow Denial

• Allow the patient to control the amount of
  information they receive.

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6 Explain If Requested

• Step by step.
• Detail will not be remembered but the way you
  explain it will be.

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7 Listen to Concerns

• What are your concerns at the moment?
• Allow time and space for answers.

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8 Encourage Ventilation of Feelings

• Acknowledge the feelings.
• Non-judgmental.
• Vital step for patient satisfaction.

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9 Summarise

• Concerns.
• Plans for treatment.
• Foster hope.
• ? Written information.

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10 Offer Further

• Availability.
• Information.
• Future needs will change.