have the most complete information in order to make the best plans for future treatment and care. The reasons our patients want us to be truthful with them is for much the same reason6.
Reinforce those parts of the information the patient has given you which are correct. This creates a shared baseline for current knowledge. Then go on to provide more information which guides the patient to a better understanding of their current situation. This should be done gently and slowly, giving the patient time to adjust to each part of the information you are giving. For instance, you can preface your remarks with a warning, for example "Mr Jones, the results of the tests are not as good as we hoped for."
This gives the patient the opportunity to set the pace and guide you with their questions and feedback. Be very careful not to blind the patient with medical language and jargon. Sometimes, we forget that some of the simple words we use are not part of everyone's vocabulary.
This point is also important when our patient is from a medical or health care background. By using a lot of medical language we may not be giving the person the chance to be the patient instead of a fellow professional, and we may also be making assumptions about a level of medical knowledge they do not actually have.
Check that the patient is following what you are saying very frequently. Interrupt your information by asking questions like "do you follow what I am saying?". This type of checking helps the patient to feel part of the conversation, invites them to speak, and helps them to feel that their feelings are important.
Presentation for the Life Planning Centre in Tokyo, Japan, 23 February 1997.
