• Rev Assoc Med Bras (1992) · Jan 2017

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

    • Carolina Rebello Pereira, Marco Antônio Marchetti Calônego, Lino Lemonica, and Guilherme Antonio Moreira de Barros.
    • Pontifícia Universidade Católica, Sorocaba, SP, Brazil.
    • Rev Assoc Med Bras (1992). 2017 Jan 1; 63 (1): 43-49.

    ObjectiveThere 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.MethodThis was a prospective study. The data were collected after specific 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.ResultsThe 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.ConclusionThe P-A-C-I-E-N-T-E Protocol proved to be suitable to the Brazilian context.

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