Promoting patient participation and shortening cancer consultations: a randomised trial.
Promoting patient participation and shortening cancer consultations: a randomised trial.
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DOI：
10.1054/bjoc.2001.2073
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发表时间：
2001-11-02
影响因子：
8.8
通讯作者：
Tattersall MH
中科院分区：
文献类型：
--
作者：
Brown RF;Butow PN;Dunn SM;Tattersall MH
病人参与医疗咨询已被证明有利于他们随后的心理健康。提问是患者积极主动的一种方式。我们研究了两种促进癌症患者提问的方法。一个是在患者与肿瘤科医生进行初次咨询之前向患者提供问题提示表。第二个是他们的肿瘤学家对问题提示表的积极认可和系统审查。318例异质性癌症患者，首次就诊于5名医学肿瘤学家和4名放射肿瘤学家之一，随机接受或不接受问题提示表。医生被随机分配到主动解决或被动回答问题提示表在随后的咨询。在咨询前评估焦虑。对磋商进行了录音和内容分析。在咨询后立即再次评估焦虑。在接下来的10天内，患者完成了评估信息需求，焦虑和满意度的问卷调查，并进行了结构化的电话采访，评估信息回忆。与对照组相比，提供问题提示表的患者询问了更多关于预后的问题，肿瘤学家向这些患者提供了更多的预后信息。提供问题提示表延长了咨询时间，增加了患者的焦虑;然而，当肿瘤学家专门针对提示表时，焦虑水平显着降低，咨询时间缩短，回忆显着改善。一个病人的问题提示表，由医生主动使用，是一个强大的除了肿瘤咨询。2001癌症研究运动
Patient participation in medical consultations has been demonstrated to benefit their subsequent psychological well being. Question asking is one way in which patients can be active. We investigated 2 means of promoting cancer patient question asking. One was the provision of a question prompt sheet to patients prior to their initial consultation with their oncologist. The second was the active endorsement and systematic review of the question prompt sheet by their oncologist. 318 patients with heterogeneous cancers, seeing one of 5 medical and 4 radiation oncologists for the first time, were randomised to either receive or not receive a question prompt sheet. Doctors were randomised to either proactively address or passively respond to the question prompt sheet in the subsequent consultation. Anxiety was assessed prior to the consultation. Consultations were audiotaped and content analysed. Anxiety was assessed again immediately following the consultation. Within the next 10 days patients completed questionnaires assessing information needs, anxiety and satisfaction and were given a structured telephone interview assessing information recall. Patients provided with a question prompt sheet asked more questions about prognosis compared with controls and oncologists gave significantly more prognostic information to these patients. Provision of the question prompt sheet prolonged consultations and increased patient anxiety; however, when oncologists specifically addressed the prompt sheet, anxiety levels were significantly reduced, consultation duration was decreased and recall was significantly improved. A patient question prompt sheet, used proactively by the doctor, is a powerful addition to the oncology consultation. © 2001 Cancer Research Campaign