Jitchaya BoonnunPrangtip Chayaput2011-02-222011-02-222010-04-012010-04-01Thai Journal of Nursing Council; Vol.24 No.3 July-September 2009; 7-19http://imsear.searo.who.int/handle/123456789/132497Disclosure of unfavorable news or “breaking bad news” in cancer patients may start at the time of making diagnosis, then, through the course of treatment continuously. It directly affects not only to patients and families causing fear, stress, and anxiety which may result in emotional and behavioral problems, but also to nurses and physicians involving in that communication or delivered information. It causes stress to them and fear to interact with those patients and families as well. Communication task for delivering unfavorable clinical information or bad news is sensitive and difficult for nurses who have no skill, experience, or guideline for communication. Nurses who take care of those patients involve many possibilities to convey in order to reassure and discuss more on the unfavorable medical information. Employing the SPIKES – Six-Step Protocol – which consists of setting up, perception, invitation, knowledge, emotion, strategy and summary, will help facilitating the effective communication. Moreover, it can be used as a guideline to establish communication skill for delivering the bad news. It helps nurses in gathering the data by using the appropriate questions and observing the reactions of patients, then, either responding to them or giving them the additional related information accurately. It also promotes and supports patients’ participation in the future treatment plan. Using SPIKES protocol will increase nurses’ confidence in communication with and being able to furnish the suitable care for those patients and families.en-USThailand Nursing and Midwifery Council, Ministry of Public Health, ThailandArticles