Division of Pediatric Surgery, Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa; Program in Bioethics and Humanities, University of Iowa Carver College of Medicine, Iowa City, Iowa.
Program in Bioethics and Humanities, University of Iowa Carver College of Medicine, Iowa City, Iowa.
J Surg Res. 2023 Dec;292:44-52. doi: 10.1016/j.jss.2023.07.029. Epub 2023 Aug 12.
Parents of children with cancer describe interactions with clinicians as emotionally distressing. Patient engagement in treatment discussions decreases decisional conflict and improves decision quality which may limit such distress. We have shown that parents prefer to engage surgeons by asking questions, but parents may not know what to ask. Question Prompt Lists (QPLs), structured lists of questions designed to help patients ask important questions, have not been studied in pediatric surgery. We developed a QPL designed to empower parents to ask meaningful questions during pediatric surgical oncology discussions. We conducted a mixed methods analysis to assess the acceptability, appropriateness, and feasibility of using the QPL.
Key stakeholders at an academic children's hospital participated in focus groups to discuss the QPL. Focus groups were recorded and transcribed. Participants were surveyed regarding QPL acceptability, appropriateness, and feasibility. Thematic content analysis of transcripts was performed.
Four parents, five nurses, five nurse practitioners, five oncologists, and four surgeons participated. Seven key themes were identified: (1) QPL as a tool of empowerment; (2) stick to the surgical details; (3) QPLs can impact discussion quality; (4) time consuming, but not overly disruptive; (5) parental emotion may impact QPL use; (6) provide QPLs prior to surgical consultation in both print and digital formats; and (7) expansion of QPLs to other disciplines. Over 70% of participants agreed that the QPL was acceptable, appropriate, and feasible.
Our novel QPL is acceptable, appropriate, and feasible to use with parents of pediatric surgical oncology patients.
患有癌症的儿童的父母描述了与临床医生的互动令人感到情绪困扰。让患者参与治疗讨论可减少决策冲突并提高决策质量，从而可能减轻这种困扰。我们已经表明，父母更愿意通过提问来与外科医生互动，但父母可能不知道该问什么。问题提示清单（QPL）是一种结构化的问题清单，旨在帮助患者提出重要问题，尚未在儿科外科中进行研究。我们开发了一种 QPL，旨在使父母能够在儿科外科肿瘤学讨论中提出有意义的问题。我们进行了混合方法分析，以评估使用 QPL 的可接受性、适当性和可行性。
学术儿童医院的主要利益相关者参加了焦点小组讨论，以讨论 QPL。焦点小组的讨论进行了记录和转录。参与者对 QPL 的可接受性、适当性和可行性进行了调查。对转录本进行了主题内容分析。
有 4 位家长、5 位护士、5 位护士从业者、5 位肿瘤学家和 4 位外科医生参加了会议。确定了 7 个关键主题：（1）QPL 作为赋权工具；（2）坚持手术细节；（3）QPL 可以影响讨论质量；（4）耗时但不会造成过度干扰；（5）父母的情绪可能会影响 QPL 的使用；（6）以印刷和数字格式在手术咨询之前提供 QPL；（7）将 QPL 扩展到其他学科。超过 70％的参与者同意 QPL 是可接受的、适当的和可行的。
我们的新型 QPL 可用于患有儿科外科肿瘤学患者的父母，具有可接受性、适当性和可行性。
