Clayton J, Butow P, Tattersall M, Chye R, Noel M, Davis J M, Glare P
Medical Psychology Research Unit, Blackburn Building D06, University of Sydney, and Sacred Heart Palliative Care Service, St Vincent's Hospital, Darlinghurst, Sydney, NSW, Australia.
Br J Cancer. 2003 Dec 1;89(11):2069-77. doi: 10.1038/sj.bjc.6601380.
Question prompt lists (QPLs) have been shown to be an inexpensive and effective communication tool for patients in oncology consultations. We aimed to develop and pilot a QPL for palliative care (PC) patients. In order to identify suitable questions for inclusion in the QPL, we conducted focus groups and individual interviews with 19 patients, 24 carers and 22 PC health professionals. A further 21 health professionals reviewed the draft document. The draft QPL was piloted in 23 patients. In total, 112 questions were identified and grouped into eight categories. All participants felt that the QPL, in booklet form, could be a useful tool. Out of 23 patients in the pilot study, 22 agreed that the QPL was helpful, contained useful questions, was easy to understand and would be useful in the future. State anxiety (STAI) decreased after receiving the booklet and seeing the doctor in 16 out of 19 patients (overall anxiety decreased by a median of 8, IQR 1-13). Participants in the pilot study endorsed the inclusion of end-of-life issues in the QPL, despite some reservations expressed about this by health professionals in the individual interviews. We have identified a specific QPL that might facilitate useful dialogue between PC patients and their doctor. The QPL has strong support from patients, their carers and relevant health professionals.
问题提示清单(QPLs)已被证明是肿瘤会诊中用于患者的一种经济有效的沟通工具。我们旨在为姑息治疗(PC)患者开发并试行一份QPL。为了确定纳入QPL的合适问题,我们对19名患者、24名护理人员和22名PC健康专业人员进行了焦点小组讨论和个人访谈。另外21名健康专业人员对文件草案进行了审核。QPL草案在23名患者中进行了试行。总共确定了112个问题,并将其分为八类。所有参与者都认为手册形式的QPL可能是一个有用的工具。在试点研究的23名患者中,22名患者同意QPL有帮助、包含有用的问题、易于理解且将来会有用。19名患者中有16名在收到手册并看过医生后状态焦虑(STAI)有所下降(总体焦虑中位数下降了8,四分位间距为1 - 13)。试点研究的参与者认可在QPL中纳入临终问题,尽管在个人访谈中一些健康专业人员对此有所保留。我们已经确定了一份特定的QPL,它可能有助于PC患者与其医生之间进行有益的对话。QPL得到了患者、其护理人员和相关健康专业人员的大力支持。