1 Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center , Houston, Texas.
2 Department of Biostatistics, The University of Texas MD Anderson Cancer Center , Houston, Texas.
J Palliat Med. 2016 Aug;19(8):883-7. doi: 10.1089/jpm.2015.0545. Epub 2016 May 13.
A question prompt sheet (QPS) is a structured list of potential questions available for patients to ask their doctor during a clinical encounter. Although it has been shown to improve physician-patient interaction during clinical consultations, there is paucity of data on its use in the palliative care setting. The aim of this study was to develop a single-page consensus list of prompt questions for use by patients attending outpatient palliative care.
An expert group of experienced physicians and mid-level providers were invited to participate in the study conducted in three Delphi rounds. A consensus in this study was defined a priori as an agreement (i.e., agree or strongly agree) by a minimum of 80% of the experts.
One hundred percent of the 22 invited experts participated in all the three Delphi rounds of the study. The top 25 questions with the highest level of endorsement were chosen and used toward the development of the QPS. Twenty-eight percent of the questions were about symptoms, treatment, and lifestyle, 24% were about commonly asked questions by caregivers, 20% were regarding end-of-life issues, 16% were regarding the nature of the palliative care service, and 12% were regarding the type of available support.
A 25-item, single-page QPS was developed for use by patients attending outpatient palliative care. Further studies are needed to determine its clinical effectiveness in assisting physician-patient communication.
问题提示表 (QPS) 是一份潜在问题的结构化清单，可供患者在临床就诊时向医生提出。尽管它已被证明可以改善临床咨询期间的医患互动，但在姑息治疗环境中使用它的数据却很少。本研究的目的是为接受姑息治疗的门诊患者制定一份单一页面的共识问题提示清单。
邀请了一组经验丰富的医生和中级医疗保健提供者作为专家组成员参与本研究，研究采用三轮德尔菲法。本研究中的共识是指至少 80%的专家达成一致（即同意或强烈同意）。
22 名受邀专家全部参加了研究的三轮德尔菲法。选择并使用得票最高的前 25 个问题来制定 QPS。其中 28%的问题与症状、治疗和生活方式有关，24%的问题与护理人员常问的问题有关，20%的问题与临终问题有关，16%的问题与姑息治疗服务的性质有关，12%的问题与可用支持的类型有关。
为接受姑息治疗的门诊患者制定了一份 25 项的单页 QPS。需要进一步研究以确定其在协助医患沟通方面的临床效果。
