Table 4.

Priority for Improvement Based on the Gap Between Satisfaction and Preferences of Cancer Patients Based on the SPIKES Model

SPIKES	Requirement	Preference i	Satisfaction S	Gap 5-S	Priority for Improvement iX Gap
(Setting)	Calm and private environment	4.7	4.2	0.83	3.88
(Setting)	Bring a family member or friend	3.9	4.1	0.85	3.31
(Perception)	Patient perception assessed by the doctor prior to diagnosis delivery	4.0	3.6	1.35	5.45*
(Invitation)	Ask the patient what information they want to know before telling diagnosis	4.4	3.8	1.21	5.26*
(Knowledge)	Doctor’s explanation of the diagnosis	4.5	3.8	1.18	5.29*
(KNWOLEDGE)	Check patient’s understanding	4.7	4.3	0.70	3.31
(Empathy)	Doctor consoles the patient by patting his/her shoulder, holding hand or hugging the patient during BBN	3.3	3.7	1.30	4.27
(Empathy)	Doctor’s empathy	4.8	4.4	0.63	3.00
(Empathy)	Spends time during the delivery of the diagnosis	4.7	4.4	0.62	2.91
(summary)	Providing a written summary after receiving the diagnosis	4.1	3.2	1.81	7.39*
Emerging themes	Doctor gives hope	4.7	4.3	0.68	3.22
	Being alone with the doctor	3.3	3.9	1.14	3.69
	Good listener and interacting doctor	4.8	4.3	0.65	3.15
	Providing a psychologist at the time of diagnosis	3.6	3.6	1.40	5.01*
	Receiving the diagnosis by a doctor the patient knew already	4.0	3.8	1.20	4.76
	Spirituality, and reminding the patient of god	4.3	4.3	0.66	2.85
	Receive the diagnosis in a direct way not gradually	2.7	3.9	1.05	2.84
	Focused doctor and not talking about unrelated topics	4.4	4.4	0.63	2.78
	Doctor has good body language and suitable tone	4.7	4.5	0.49	2.29
	Simple, smooth explanation by the doctor without using medical terms	4.8	4.5	0.47	2.25
	Smiling, joyful and magnanimous doctor	4.7	4.5	0.47	2.21
	Using alternative words of cancer by the doctor	3.2	4.3	0.66	2.12
	Honest and encouraging doctor	4.8	4.6	0.42	2.05

Note: *Items with highest priority for improvement.