physicians’ skills in breaking bad news to patients with cancer using spikes protocol

Background: breaking bad news is an unpleasant task for physicians, especially for patients with cancer.in this regard, the spikes protocol, which is prevalent in several countries, has not been discussed in iran.objectives: this study evaluated how the spikes protocol was followed by physicians. materials & methods: this descriptive cross-sectional study was conducted at guilan academichospitals from december 2021 to april 2022. patients with cancer participated in the survey who werereferred to the oncology academic centers for follow-ups or radiotherapy and chemotherapy. they wereover 18 years old with the ability of proper communication. the spikes questionnaire consists of 12questions with 6 subscales (settings, invitation, perception, knowledge, emotion, and strategy). it wasfilled out through a direct interview.results: the data from 280 patients were analyzed. everyone stated that at the time of receiving thediagnosis, the doctor was not in a hurry and made appropriate eye contact. about 61.1% believed theywere emotionally supported, and 65.4% were satisfied with their final knowledge about the disease andtreatment planning. patients with older ages and lower levels of education were significantly more likelyto state that physicians’ language was not comprehensive; physicians did not understand them, and thepatients were not emotionally supported (p=0.0001).conclusion: this study showed that more attention should be paid to older patients with lower levels ofeducation. they needed more time for conversation and simpler dialect. some areas, such as “invitation”are required to be improved.