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•
Advance preparation-
-arrange adequate time and privacy,
confirm medical facts, review relevant clinical data, and
emotionally prepare for the encounter.
•
Building a therapeutic relationship-identify patient
preferences
regarding the disclosure of bad news.
•
Communicating well-
-determine the patient's knowledge
and understanding of the situation, proceed at the patient's
pace, avoid medical jargon or euphemisms, allow for
silence and tears, and answer questions.
•
Dealing with patient and family reactions-
-assess and
respond to emotional reactions and empathize with the
patient.
•
Encouraging/validating emotions-
-offer realistic hope
based on the patient's goals and deal with your own needs.
Consolar siempre…
ABDCE Plan
American Family Physician, 2001