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Denial and communication 

Denial and communication

Chapter:
Denial and communication
Author(s):

Linda Sheahan

and David W. Kissane

DOI:
10.1093/med/9780198736134.003.0016
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date: 26 June 2017

Patients who appear not to acknowledge the diagnosis or severity of an illness may be ‘in denial’. Denial will be examined on a spectrum from maladaptive to beneficial outcomes, exploring how it functions within the palliative care setting. We consider when intervention is appropriate and how that intervention is best undertaken. Specific attention is given to the communication skills required for an effective clinical response to denial. Although the term ‘denial’ is an accepted part of the medical vernacular, it is used in a variety of clinical circumstances, with varying definitions and little consensus. This chapter establishes a pragmatic view of denial, explores how it functions within the clinician-patient relationship, and then demonstrates when intervention is appropriate and how that intervention is best undertaken. Specific attention will be given to the communication skills required for an effective clinical response to denial.

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