Focused HISTORY
• Red flags Hx – No new symptoms
• Risk factors – Pt may ask about relation with disease in 2nd half
Figure out SUPPORT system/Psychosocial situation/Social Hx
• Who’s at home
• Married/children – Where are they at this point?
• Do you want them to be here
• How much do they know
• What do you for your job?
• Do you have plans coming up related to job/ with family/friends?
2ND HALF
BBN – Give in STAGGERED steps, WAIT reaction. BEST TO WORST case scenario
• Unfortunately, it doesn’t look good as we thought. There may be a little
shadow on the X-ray, shadow can mean things that can be serious, it could
indicate a potential mass, mass could be things like tumour, tumour could be
things like Ca.
• Unfortunately, the X-ray report wasn’t as clear as we like, we have seen a little
shadow that sits ___, there are many causes, best case – infections, they can
present as shadow like this, we don’t worry about those too much. But when
we see shadow like this on the chest X-ray with your story, we just need to
make sure we’re not missing what we call the worst case scenario here, and by
that I mean things like Ca.
• I can see this is a lot to take in. Please take your time, there’s no rush.
Involve SUPPORT system in 1st half.
• You mentioned your _____(e.g. husband/children), would you like me to give
them a call? Perhaps get them here and maybe discuss about this with them. Do
you think that would help?
ANSWER question
• I can understand this information would cause a lot of questions in your mind.
Unfortunately, at this point, I don’t have all of those answers and I don’t want
to give you any false information but what I’d like to talk about is the thing
that we could do now to try move things forward so we can hopefully get some
of these answers for you
ONGOING communication
• Please don’t hesitate to ask if you have any more queries after this, I’m sure
many more Qs will come to your mind. So please contact me or any of the
staffs if you any of those Qs
• Please don’t feel alone. We are here to help you
• And please also mention this to your family if they have any Qs, ask them to get
in touch.