Estrategia de simulación para aplicar el protocolo SPIKES en la comunicación de malas noticias
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may 7, 2020
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Gladys Cecilia Gordillo Navas
https://orcid.org/0000-0002-2368-2898
Javier David Trujillo Martínez
https://orcid.org/0000-0002-0059-4342
Juan David Filizzola Bermúdez
https://orcid.org/0000-0001-5939-1104
https://orcid.org/0000-0002-2368-2898
Javier David Trujillo Martínez
https://orcid.org/0000-0002-0059-4342
Juan David Filizzola Bermúdez
https://orcid.org/0000-0001-5939-1104
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Resumen
En el campo de la salud, las malas noticias se definen como cualquier información que altere drástica y negativamente la visión del paciente sobre su futuro. La comunicación de malas noticias es de gran relevancia en la práctica clínica; sin embargo, a pesar de su importancia, la formación de los profesionales de salud frente a la adquisición de esta habilidad es deficiente. La entrega hábil de malas noticias puede proporcionar comodidad para el paciente y su familia; no obstante, una mala comunicación puede generar reacciones emocionales negativas, perspectivas erróneas sobre el pronóstico clínico e incluso tener implicaciones legales. La literatura describe varios protocolos y herramientas que favorecen la adecuada entrega de malas noticias, así como estrategias académicas que facilitan su aprendizaje. Este artículo propone una reflexión sobre el uso de escenarios simulados para el entrenamiento de profesionales de la salud, en comunicación de malas noticias, utilizando el protocolo SPIKES.
Keywords
Simulación, comunicación, educación en salud, paciente simulado, malas noticias, SPIKES
References
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2. Sarwar MZ, Rehman F, Fatima SM, et al. Breaking bad news skill of postgraduate residents of tertiary care hospital of Lahore, Pakistan: A cross-sectional survey. J Pak Med Assoc [Internet]. 2019;69(5):695–9. Available from: https://www.semanticscholar.org/paper/Breaking-bad-news-skill-of-postgraduate-residents-A-Sarwar-Rehman/cc5609b398e8fa55a51f39fe26d378a8bb55cd14
3. Nielsen PE, Munroe M, Foglia L, et al. Collaborative Practice Model: Improving the delivery of bad news. Clin J Oncol Nurs. 2012;22(1):23–7
4. Franklin J, Berkey D, Joseph P, et al. Delivering bad or life-altering news. Am Fam Physician [Internet]. 2018;98(2):99–104. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L623051532
5. Karam VY, Barakat H, Aouad M, et al. Effect of a simulation-based workshop on breaking bad news for anesthesiology residents: An intervention study. BMC Anesthesiol. 2017;17(1):4–9
6. Huarcaya-victoria J, Infanto SD, Nacional H, et al. El duelo y cómo dar malas noticias en medicina. An Fac med [Internet]. 2019;80(1):86–91. Available from: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1025-55832019000100016
7. Martín Hernández I, Trujillo Matienzo C. Comunicación de malas noticias a pacientes con enfermedades neurodegenerativas: habilidades del personal médico. Rev Latinoam Bioética [Internet]. 2009;9(2):77–85. Available from: http://portal.amelica.org/ameli/jatsRepo/127020306006
8. Eid A, Petty M, Hutchins L, et al. Breaking bad news: Standardized patient intervention improves communication skills for hematology-oncology fellows and advanced practice nurses. J Cancer Educ. 2009;24(2):154–9
9. Ramírez-Ibáñez MT, Ramírez-de la Roche OF. Cómo comunicar malas noticias en la práctica médica. Atención Fam [Internet]. 2015;22(4):95–6. Available from: https://www.elsevier.es/es-revista-atencion-familiar-223-articulo-como-comunicar-malas-noticias-practica-S1405887116300608
10. Baile W, Buckman R, Lenzi R, et al. SPIKES--A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer. Oncologist [Internet]. 2000;5(4):302–11. Available from: http://theoncologist.alphamedpress.org/content/5/4/302.long
11. Cleland JA, Abe K, Rethans JJ. The use of simulated patients in medical education: AMEE Guide No 42 1. Med Teach. 2009;31(6):477–86
12. Parvan K, Hosseini FA, Bagherian S. Simulated patient and role play methodologies for communication skills training in an undergraduate medical program: Randomized, crossover trial. Educ Heal [Internet]. 2018;31:10–6. Available from: http://www.educationforhealth.net/article.asp?issn=1357-6283;year=2018;volume=31;issue=1;spage=10;epage=16;aulast=Taylor
13. Negri EC, Mazzo A, Martins JCA, et al. Simulação clínica com dramatização: Ganhos percebidos por estudantes e profissionais de saúde. Rev Lat Am Enfermagem. 2017;25
14. Dosanjh S, Barnes J, Bhandari M. Barriers to breaking bad news among medical and surgical residents. Med Educ. 2001;35(3):197–205
15. Brown VA, Parker PA, Furber L, et al. Patient preferences for the delivery of bad news - the experience of a UK Cancer Centre. Eur J Cancer Care (Engl). 2011;20(1):56–61
16. Oikonomidou D, Anagnostopoulos F, Dimitrakaki C, et al. Doctors’ Perceptions and Practices of Breaking Bad News: A Qualitative Study From Greece. Health Commun. 2017;32(6):657–66
17. Abbas S, Muhammad S, Mubeen S, et al. Awareness of palliative medicine among Pakistani doctors: a survey. J Pak Med Assoc. 2004; 54:195-8
18. Jameel A, Noor SM, Ayub S. Survey on perceptions and skills amongst postgraduate residents regarding breaking bad news at teaching hospitals in Peshawar, Pakistan. JPak Med Assoc. 2012; 62:585
19. Rat A, Ricci L, Guillemin F, et al. Development of an online formative self-assessment tool for physicians to practice breaking bad news: the Breaking bad news Tool (BRADNET). JMIR Med Educ. 2018;4(2):1–27
20. Beigzadeh A, Bahmanbijari B, Sharifpoor E, et al. Standardized patients versus simulated patients in medical education: are they the same or different. J Emerg Pract Trauma [Internet]. 2015;2(1):25–8. Available from: http://www.jept.ir/article_10855_cb64e5d76610f95fd11365cde44e499b.pdf
21. Kaplonyi J, Bowles KA, Nestel D, et al. Understanding the impact of simulated patients on health care learners’ communication skills: a systematic review. Med Educ. 2017;51(12):1209–19
22. Laughey W, Sangvik Grandal N, M Finn G. Medical communication: the views of simulated patients. Med Educ. 2018;52(6):664–76
23. Wallace J, Rao R, Haslam R. Pacientes simulados y exámenes clínicos estructurados objetivos: revisión de su uso en educación médica. Avances en el tratamiento psiquiátrico. Prensa de la Universidad de Cambridge; 2002; 8 (5): 342–8.
2. Sarwar MZ, Rehman F, Fatima SM, et al. Breaking bad news skill of postgraduate residents of tertiary care hospital of Lahore, Pakistan: A cross-sectional survey. J Pak Med Assoc [Internet]. 2019;69(5):695–9. Available from: https://www.semanticscholar.org/paper/Breaking-bad-news-skill-of-postgraduate-residents-A-Sarwar-Rehman/cc5609b398e8fa55a51f39fe26d378a8bb55cd14
3. Nielsen PE, Munroe M, Foglia L, et al. Collaborative Practice Model: Improving the delivery of bad news. Clin J Oncol Nurs. 2012;22(1):23–7
4. Franklin J, Berkey D, Joseph P, et al. Delivering bad or life-altering news. Am Fam Physician [Internet]. 2018;98(2):99–104. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L623051532
5. Karam VY, Barakat H, Aouad M, et al. Effect of a simulation-based workshop on breaking bad news for anesthesiology residents: An intervention study. BMC Anesthesiol. 2017;17(1):4–9
6. Huarcaya-victoria J, Infanto SD, Nacional H, et al. El duelo y cómo dar malas noticias en medicina. An Fac med [Internet]. 2019;80(1):86–91. Available from: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1025-55832019000100016
7. Martín Hernández I, Trujillo Matienzo C. Comunicación de malas noticias a pacientes con enfermedades neurodegenerativas: habilidades del personal médico. Rev Latinoam Bioética [Internet]. 2009;9(2):77–85. Available from: http://portal.amelica.org/ameli/jatsRepo/127020306006
8. Eid A, Petty M, Hutchins L, et al. Breaking bad news: Standardized patient intervention improves communication skills for hematology-oncology fellows and advanced practice nurses. J Cancer Educ. 2009;24(2):154–9
9. Ramírez-Ibáñez MT, Ramírez-de la Roche OF. Cómo comunicar malas noticias en la práctica médica. Atención Fam [Internet]. 2015;22(4):95–6. Available from: https://www.elsevier.es/es-revista-atencion-familiar-223-articulo-como-comunicar-malas-noticias-practica-S1405887116300608
10. Baile W, Buckman R, Lenzi R, et al. SPIKES--A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer. Oncologist [Internet]. 2000;5(4):302–11. Available from: http://theoncologist.alphamedpress.org/content/5/4/302.long
11. Cleland JA, Abe K, Rethans JJ. The use of simulated patients in medical education: AMEE Guide No 42 1. Med Teach. 2009;31(6):477–86
12. Parvan K, Hosseini FA, Bagherian S. Simulated patient and role play methodologies for communication skills training in an undergraduate medical program: Randomized, crossover trial. Educ Heal [Internet]. 2018;31:10–6. Available from: http://www.educationforhealth.net/article.asp?issn=1357-6283;year=2018;volume=31;issue=1;spage=10;epage=16;aulast=Taylor
13. Negri EC, Mazzo A, Martins JCA, et al. Simulação clínica com dramatização: Ganhos percebidos por estudantes e profissionais de saúde. Rev Lat Am Enfermagem. 2017;25
14. Dosanjh S, Barnes J, Bhandari M. Barriers to breaking bad news among medical and surgical residents. Med Educ. 2001;35(3):197–205
15. Brown VA, Parker PA, Furber L, et al. Patient preferences for the delivery of bad news - the experience of a UK Cancer Centre. Eur J Cancer Care (Engl). 2011;20(1):56–61
16. Oikonomidou D, Anagnostopoulos F, Dimitrakaki C, et al. Doctors’ Perceptions and Practices of Breaking Bad News: A Qualitative Study From Greece. Health Commun. 2017;32(6):657–66
17. Abbas S, Muhammad S, Mubeen S, et al. Awareness of palliative medicine among Pakistani doctors: a survey. J Pak Med Assoc. 2004; 54:195-8
18. Jameel A, Noor SM, Ayub S. Survey on perceptions and skills amongst postgraduate residents regarding breaking bad news at teaching hospitals in Peshawar, Pakistan. JPak Med Assoc. 2012; 62:585
19. Rat A, Ricci L, Guillemin F, et al. Development of an online formative self-assessment tool for physicians to practice breaking bad news: the Breaking bad news Tool (BRADNET). JMIR Med Educ. 2018;4(2):1–27
20. Beigzadeh A, Bahmanbijari B, Sharifpoor E, et al. Standardized patients versus simulated patients in medical education: are they the same or different. J Emerg Pract Trauma [Internet]. 2015;2(1):25–8. Available from: http://www.jept.ir/article_10855_cb64e5d76610f95fd11365cde44e499b.pdf
21. Kaplonyi J, Bowles KA, Nestel D, et al. Understanding the impact of simulated patients on health care learners’ communication skills: a systematic review. Med Educ. 2017;51(12):1209–19
22. Laughey W, Sangvik Grandal N, M Finn G. Medical communication: the views of simulated patients. Med Educ. 2018;52(6):664–76
23. Wallace J, Rao R, Haslam R. Pacientes simulados y exámenes clínicos estructurados objetivos: revisión de su uso en educación médica. Avances en el tratamiento psiquiátrico. Prensa de la Universidad de Cambridge; 2002; 8 (5): 342–8.
Cómo citar
Gordillo Navas, G. C., Trujillo Martínez, J. D., & Filizzola Bermúdez, J. D. (2020). Estrategia de simulación para aplicar el protocolo SPIKES en la comunicación de malas noticias. Universitas Medica, 61(3). https://doi.org/10.11144/Javeriana.umed61-3.spik
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