The P-A-C-I-E-N-T-E Protocol: An instrument for breaking bad news adapted to the Brazilian medical reality

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2017-01-01

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Objective: There are plenty of published tools for breaking bad medical news; however, none of them is culturally appropriate to our reality or published in the Brazilian literature. This study proposes a genuinely Brazilian communication tool and evaluates its acceptance among doctors and nurses. Method: This was a prospective study. The data were collected after specifc training of doctors and nurses on the bad news communication techniques based on the P-A-C-I-E-N-T-E (patient, in Portuguese) Protocol. This instrument is in accordance with the Brazilian reality and was based on the SPIKES communication tool. Results: The worst task to be performed during communication is talking about death followed by discussing the end of curative treatment attempts and diagnosis itself. Among the respondents, 48% reported they did not receive formal training for communicating. Also, 52% of respondents do not use any systematic approach in their daily practice when communicating with patients, but 97% considered the proposed P-A-C-I-E-N-T-E Protocol as a useful and appropriate communication tool. Conclusion: The P-A-C-I-E-N-T-E Protocol proved to be suitable to the Brazilian context.

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Revista da Associacao Medica Brasileira, v. 63, n. 1, p. 43-49, 2017.

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