University of North Carolina, Chapel Hill, North Carolina.
RTI International, Center for Communication Science, Research Triangle Park, North Carolina.
J Card Fail. 2022 Jun;28(6):896-905. doi: 10.1016/j.cardfail.2021.11.012. Epub 2021 Nov 21.
Question prompt lists (QPLs) are an effective tool for improving communication during medical visits. However, no studies have attempted to correlate intentions related to question asking and actual questions asked during visits. Moreover, few studies have used QPLs with patients with heart failure (HF) or family companions who accompany them to visits. We examined the use of a previsit QPL for patients with HF and their family companions intended to enhance engagement in HF care. The aim of this research was to assess which questions from the QPL patients and companions selected most frequently to ask and compare this item with which questions were actually asked during the medical visit.
This secondary analysis of QOLs and audiotaped visit data from a pilot study enrolled and consented patients with HF, family companions, and HF clinicians. A single group of 30 patients with HF and 23 family companions received the QPL to complete in the waiting room immediately before their cardiology visit. To meet our aims, we calculated the frequencies for each question selected and asked from the QPL, using data derived from completed prompt lists and audiotaped medical visits. A follow-up survey was administered 2 days after the appointment to assess differences in how participants filled out and used the prompt list. Patients and companions primarily selected and asked questions from the QPL regarding the management and treatment of the disease, general questions about HF, and questions about prognosis. Participants rarely asked questions about support for family and friends or health care team roles and responsibilities. Patients and companions did not ask many of the questions they reported wanting to ask.
Prompt lists may empower patients and companions to communicate with their clinician by identifying important questions to help overcome patients' and companions' knowledge gaps. More research is needed to understand the true impact of prompt lists on patient-family-clinician communication and subsequent HF outcomes, and how best to implement them in clinical workflows to increase their potential usefulness.
问题提示清单（QPL）是改善医疗就诊期间沟通的有效工具。然而，尚无研究试图将与提问相关的意图与就诊期间实际提出的问题相关联。此外，很少有研究在心力衰竭（HF）患者或陪伴他们就诊的家属中使用 QPL。我们检查了心力衰竭患者及其家属在就诊前使用 QPL 以增强对 HF 护理的参与度。本研究的目的是评估 QPL 中患者和家属最常选择询问的问题，并将其与就诊期间实际询问的问题进行比较。
这项对试点研究的生活质量和录音就诊数据的二次分析纳入并同意了 HF 患者、家属和 HF 临床医生。一组 30 名 HF 患者和 23 名家属接受了 QPL，以便在心脏病就诊前在候诊室完成。为了达到我们的目的，我们使用从已完成的提示清单和录音就诊中得出的数据，计算了从 QPL 中选择和询问的每个问题的频率。在预约后两天进行了后续调查，以评估参与者填写和使用提示清单的差异。患者和家属主要从 QPL 中选择和询问与疾病管理和治疗、HF 一般问题以及预后问题相关的问题。参与者很少询问有关支持家人和朋友或医疗保健团队角色和责任的问题。患者和家属没有提出他们报告想要询问的许多问题。
提示清单可以通过确定有助于克服患者和家属知识差距的重要问题，使患者和家属能够与他们的临床医生进行沟通。需要进一步研究以了解提示清单对患者-家庭-临床医生沟通以及随后 HF 结局的真正影响，以及如何最好地将其纳入临床工作流程以增加其潜在有用性。
