Kelompok 3Pembimbing:Dr.Rizma Adlia Syakurah, MARSBreaking Bad News

Anggota KelompokMira MariantiChoiriahMelaniBella Fadillah HaisM. Febriandi JunaidiAlpasca FirdausM. Falih Akbar

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Pendahuluan *

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TujuanUntuk mengetahui cara penyampaian berita buruk kepada pasien

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TINJAUAN PUSTAKA*

Bad News*

Contoh Berita Buruk*

Penyampaian berita buruk adalah suatu hal yang sering harus dilakukan dokter maupun dokter gigi,Misalnya pada waktu dokter harus menyampaikan berita kematian, menyampaikan diagnosis suatu penyakit dengan prognosis yang tidak baik, atau menyampaikan rencana terapi yang mengandung resiko yang tinggi.Penyampaian berita buruk selalu akan menimbulkan frustasi pada pihak pasien

Tiga faktor penyebab sulinya penyampaian kabar buruk*

Tujuan*Breaking Bad News

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Mengapa BBN merupakan suatu keteramilan yg kritis?*

Kepentingan penyampaian berita buruk

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Protokol penyampaian berita buruk (Robert Buckman)*

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Setting up the interviewPersiapkan diriPrivasi pasienLibatkan pendampingListening mode: ONAvailabilityMembangun hubungan dan membina raport

Perception of the patientTentukan apa yang pasien tahu tentang kondisi medis dirinya sendiri dan harapannya terhadap hasil medikasi yang telah ditempuh

Tujuan: menilai kesenjangan antara persepsi dan harapan dengan kenyataan sebagai pertimbangan penyampaian kabar buruk

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Invitation to share InformationTanyakan apakah pasien ingin tahu perkembangan mengenai keadaannya dan/atau pengobatannya

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Knowledge transmissionWarning shotGunakan bahasa yang dimengerti pasienSampaikan informasi sedikit demi sedikitSesuaikan dengan tingkat pendidikan, latar belakang sosiokultural, dan kondisi emosional pasienIntonasi jelas, lembut, tempo yang tepatMemberi respon terhadap reaksi pasienMemberi fakta yang akurat tentang kondisi, pilihan terapi, dan prognosis

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Explore Emotion and EmpathizeAmati selalu ekspresi dan emosi pasienIdentifikasi sumber/penyebab emosiBeri pasien waktu untuk mengekpresikan perasaannyaTunjukkan pengertianMemberikan responEmpati

- Explore emotions and sympathize Prepare to give an empathetic response:1. Identify emotion expressed by the patient (sadness, silence, shock etc.)2. Identify cause/source of emotion3. Give the patient time express his or her feelings, then respond in a way that demonstrates youhave recognized connection between 1 and 2.*

Explore Emotion and Empathize

N aming the feeling I know this is upsetting U nderstanding It would be for anyone R especting Youre asking all the right questions S upporting Ill do everything I can to help you through this.

- Explore emotions and sympathize Prepare to give an empathetic response:1. Identify emotion expressed by the patient (sadness, silence, shock etc.)2. Identify cause/source of emotion3. Give the patient time express his or her feelings, then respond in a way that demonstrates youhave recognized connection between 1 and 2.*

Summarize and StrategizeSimpulkan bad news secara bertahapSimpulkan tanggapan pasienBerikan pasien kesempatan bertanyaBerikan feed backTerdokumentasi dalam rekam medisDiskusikan rencana berikutnya

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Kaye Model*

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Kesimpulan*

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The task of breaking bad news is a testing ground for the entire range of our professional skills and abilities. If we do it badly, the patients or family members may never forgive us; if we do it well, they will never forget us.

Robert Buckman

DEATH NOTIFICATIONTry to do in personBe honestBe there; silence supportAsk about viewing/body care/bathing, cultural/religious rituals, others that need to be informed. Take as much time as needed.Watch for abnormal grief reactionsElicit support systemBe sensitive about asking about funeral/autopsySet up follow-up

*Change in condition, could you come to the hospital/home get them before they enter patient roomDont be sorry

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The SPIKES protocol for breaking bad news has four objectives: Gathering information from the patient Transmitting the medical information Providing support to the patient Eliciting patients collaboration in developing a strategy or treatment for the future.Strategy for*

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*- Explore emotions and sympathize Prepare to give an empathetic response:1. Identify emotion expressed by the patient (sadness, silence, shock etc.)2. Identify cause/source of emotion3. Give the patient time express his or her feelings, then respond in a way that demonstrates youhave recognized connection between 1 and 2.*- Explore emotions and sympathize Prepare to give an empathetic response:1. Identify emotion expressed by the patient (sadness, silence, shock etc.)2. Identify cause/source of emotion3. Give the patient time express his or her feelings, then respond in a way that demonstrates youhave recognized connection between 1 and 2.*

**Change in condition, could you come to the hospital/home get them before they enter patient roomDont be sorryThe SPIKES protocol for breaking bad news has four objectives: Gathering information from the patient Transmitting the medical information Providing support to the patient Eliciting patients collaboration in developing a strategy or treatment for the future.Strategy for*