HomeGuidelinesWhat does the patient know or suspect?     Most patients will have some idea of what their symptoms might mean. Others may have had some previous information from their doctor. It is important to establish what the patient knows or suspects before giving further information. Questions might include: •  Have you any idea of what might be wrong?   •  How would you describe your illness?   •  How worried have you been about your illness?   •  What did you understand about your condition from the other doctor?   •  What tests have you had?   •  When you first had symptom X, what did you think it might be?   •  What did Doctor X tell you when he sent you here?   •  When did you first think something serious was going on?   Occasionally a patient (or a parent if the patient is a child) will fall silent and seem completely unprepared or unable to respond. It may help to acknowledge this eg. "You seem to be finding it hard to talk about this". Give some time before speaking again, and if there is still no response (unlikely), offer to see the patient again, with a chosen person present. Acknowledge that it can be hard to talk about distressing issues. Use silence effectively and do not be tempted to rush on with the interview Mrs. Jones has noticed that one of her legs becomes swollen during the day. She also has "Tummy upsets" with a burning sensation. Her GP has prescribed antacids and a mild diuretic, but has now referred her to the Oncology clinic for further investigations. •  Formulate some questions, which you might ask her, to establish her current knowledge, or suspicions, of why she has been referred to your clinic.        Printer friendly version  Click here	A time to share Getting started What does the patient know or suspect? Give information at patient's pace Sharing the information Giving space Handling reactions Planning and follow up Do's and don'ts