Arthur Joseph, Yennu Sriram, Zapata Kresnier Perez, Cantu Hilda, Wu Jimin, Liu Diane, Bruera Eduardo
Department of Palliative Care & Rehabilitation Medicine, The University of Texas MD Anderson Cancer, Houston, Texas, USA.
Department of Palliative Care & Rehabilitation Medicine, The University of Texas MD Anderson Cancer, Houston, Texas, USA.
J Pain Symptom Manage. 2017 Jan;53(1):124-130.e1. doi: 10.1016/j.jpainsymman.2016.08.017. Epub 2016 Oct 12.
Data on the use of question prompt sheets (QPSs) in palliative care are limited. Our team previously developed a single-page QPS using a Delphi process. The main objective of this study was to determine the perception of helpfulness of a QPS in patient-physician communication among advanced cancer outpatients.
Hundred of 104 (96%) eligible patients and 68/68 (100%) caregivers received the QPS during their first palliative care clinic. Twelve palliative medicine specialists also participated in the study. Patient and physician perceptions about the QPS were assessed at the end of the visit. Patients' anxiety was also measured before and after consultation using the Spielberger State Anxiety Inventory.
Among the responders, most agreed that the material was helpful in communicating with their doctor (77%), clear to understand (90%), had the right amount of information (87%), and they would use a similar material in the future (76%) and recommend it to other patients (70%). Overall, 92% were satisfied with their consultation visit. Physicians perceived that the QPS was helpful in 68% of the encounters and it did not prolong the consultation in 73% of the encounters. Physician agreement on helpfulness of the QPS was not significantly different from that of the patients (P = 0.3). Patient anxiety improved after consultation from a mean (SD) Spielberger State Trait Anxiety Inventory score of 39.2 (12.8) to 33.8 (10.7), P < 0.0001).
The QPS was perceived as helpful in patient-physician communication among advanced cancer outpatients and it did not increase patient anxiety. Physicians similarly reported that the QPS was helpful and it did not prolong clinic visits. Further research is needed for its widespread adoption and integration into routine clinical practice.
关于在姑息治疗中使用问题提示单（QPS）的数据有限。我们的团队之前通过德尔菲法开发了一份单页QPS。本研究的主要目的是确定QPS在晚期癌症门诊患者医患沟通中对帮助程度的认知。
104名符合条件的患者中有100名（96%）以及68名/68名（100%）护理人员在其首次姑息治疗门诊时收到了QPS。12名姑息医学专家也参与了该研究。在就诊结束时评估患者和医生对QPS的看法。还使用斯皮尔伯格状态焦虑量表在咨询前后测量患者的焦虑程度。
在回复者中，大多数人同意该材料有助于与医生沟通（77%）、易于理解（90%）、信息量适中（87%），并且他们将来会使用类似的材料（76%）并推荐给其他患者（70%）。总体而言，92%的人对他们的咨询就诊感到满意。医生认为QPS在68%的会诊中是有帮助的，并且在73%的会诊中没有延长咨询时间。医生对QPS帮助程度的认同与患者没有显著差异（P = 0.3）。咨询后患者焦虑程度有所改善，斯皮尔伯格状态特质焦虑量表平均得分从39.2（12.8）降至33.8（10.7），P < 0.0001）。
QPS被认为有助于晚期癌症门诊患者的医患沟通，并且没有增加患者的焦虑。医生同样报告说QPS是有帮助的，并且没有延长门诊就诊时间。需要进一步研究以使其广泛应用并融入常规临床实践。
