Eggly Susan, Hamel Lauren M, Foster Tanina S, Albrecht Terrance L, Chapman Robert, Harper Felicity W K, Thompson Hayley, Griggs Jennifer J, Gonzalez Richard, Berry-Bobovski Lisa, Tkatch Rifky, Simon Michael, Shields Anthony, Gadgeel Shirish, Loutfi Randa, Ali Haythem, Wollner Ira, Penner Louis A
Wayne State University/Karmanos Cancer Institute, 4100 John R, Detroit, MI, USA.
Wayne State University/Karmanos Cancer Institute, 4100 John R, Detroit, MI, USA.
Patient Educ Couns. 2017 May;100(5):818-826. doi: 10.1016/j.pec.2016.12.026. Epub 2016 Dec 27.
Communication during racially-discordant interactions is often of poor quality and may contribute to racial treatment disparities. We evaluated an intervention designed to increase patient active participation and other communication-related outcomes during interactions between Black patients and non-Black oncologists.
Participants were 18 non-Black medical oncologists and 114 Black patients at two cancer hospitals in Detroit, Michigan, USA. Before a clinic visit to discuss treatment, patients were randomly assigned to usual care or to one of two question prompt list (QPL) formats: booklet (QPL-Only), or booklet and communication coach (QPL-plus-Coach). Patient-oncologist interactions were video recorded. Patients reported perceptions of the intervention, oncologist communication, role in treatment decisions, and trust in the oncologist. Observers assessed interaction length, patient active participation, and oncologist communication.
The intervention was viewed positively and did not increase interaction length. The QPL-only format increased patient active participation; the QPL-plus-Coach format decreased patient perceptions of oncologist communication. No other significant effects were found.
This QPL booklet is acceptable and increases patient active participation in racially-discordant oncology interactions. Future research should investigate whether adding physician-focused interventions might improve other outcomes.
This QPL booklet is acceptable and can improve patient active participation in racially-discordant oncology interactions.
种族不和谐互动中的沟通质量往往较差，可能会导致种族治疗差异。我们评估了一项干预措施，旨在增加黑人患者与非黑人肿瘤学家互动期间患者的积极参与度以及其他与沟通相关的结果。
参与者为美国密歇根州底特律市两家癌症医院的18名非黑人医学肿瘤学家和114名黑人患者。在门诊讨论治疗之前，患者被随机分配到常规护理组或两种问题提示清单（QPL）形式之一：手册（仅QPL）或手册加沟通教练（QPL加教练）。患者与肿瘤学家的互动进行了视频记录。患者报告了对干预措施、肿瘤学家沟通、在治疗决策中的作用以及对肿瘤学家的信任的看法。观察者评估了互动时长、患者的积极参与度以及肿瘤学家的沟通情况。
该干预措施得到了积极评价，且未增加互动时长。仅QPL形式增加了患者的积极参与度；QPL加教练形式降低了患者对肿瘤学家沟通的看法。未发现其他显著影响。
这本QPL手册是可接受的，并增加了患者在种族不和谐的肿瘤学互动中的积极参与度。未来的研究应调查增加以医生为重点的干预措施是否可能改善其他结果。
这本QPL手册是可接受的，并且可以提高患者在种族不和谐的肿瘤学互动中的积极参与度。
