SPIKES

Setting

• A comfortable, quiet and private room
• Have tissues available
• Ensure you have uninterrupted time during the meetin
• Consider other support staff that should presen
• Ask the patient if they want anyone to be with them or ask if the patient would prefer to be told alone

Perception

• Discuss the events leading up to now
• Discuss the symptoms the patient may have been experiencing up to this point
• Establish what the patient already knows or is expecting
• Establish the patient’s current emotional state and if there is anything particular on the patient’s mind
• Establish if the patient is aware of the possible diagnoses

Invitation

• Check if the patient wants to receive their results today Find out how much detailed information the patient wants regarding diagnosis and prognosis

Knowledge

• Use a warning phrase to indicate that you have unfortunate news. “As you know we took a biopsy and unfortunately the results were not as we hoped”
• Allow a large pause if necessary, so the patient is able to digest what you told them