Engaging Patients to Ask More Questions: What's the Best Way? A Pragmatic Randomized Controlled Trial.
Engaging Patients to Ask More Questions: What's the Best Way? A Pragmatic Randomized Controlled Trial.
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DOI：
10.1016/j.jhsa.2021.02.001
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Kamal RN
中科院分区：
文献类型：
--
作者：
Roe AK;Eppler SL;Shapiro LM;Satteson ES;Yao J;Kamal RN
手部疾病很常见，通常需要讨论不同治疗方案的权衡。我们的目标是评估是否为患者提供常见手部疾病的问题提示列表（QPL）与为患者提供3个通用问题相比，可以提高他们对护理的感知参与度。我们进行了一项前瞻性、单中心、实用的随机对照试验。我们为常见手部疾病的患者制作了一本QPL小册子。在2019年4月至2019年7月期间招募了具有常见手部疾病的新患者，并随机分配到QPL组（35个手部特定问题）或AskShareKnow组（3个通用问题：[1]我的选择是什么？[2]这些选择可能带来的好处和危害是什么？[3]这些好处和伤害发生在我身上的可能性有多大？）。两组患者在与外科医生会面之前都收到了这些问题。我们使用感知参与护理量表（PICS），一个有效的工具，旨在评估患者参与决策，作为我们的主要结果。PICS的最高分数为13分，分数越高表示参与感越强。126名患者参加了这项研究，其中63名患者在QPL组，63名患者在AskShareKnow组。两组的人口统计学特征相似。平均AskShareKnow组PICS评分为8.3 ± 2.2，平均QPL PICS评分为7.5 ± 2.8，认为无临床意义。与向患者提供3个通用问题相比，QPL并没有增加手部疾病患者对护理的感知参与。已经评估了各种方法，以帮助改善患者参与他们的护理。在手外科中，3个通用问题与患者参与护理的冗长QPL没有什么不同。
Hand conditions are common, and often require a discussion of the tradeoffs of different treatment options. Our goal was to evaluate whether providing patients with a Question Prompt List (QPL) for common hand conditions improves their perceived involvement in care compared with providing patients with 3 generic questions. We performed a prospective, single-center, pragmatic randomized controlled trial. We created a QPL pamphlet for patients with common hand conditions. New patients with common hand conditions were enrolled between April 2019 and July 2019 and were randomized into either the QPL group (with 35 hand-specific questions) or the AskShareKnow group (3 generic questions: [1] What are my options? [2] What are the possible benefits and harms of those options? [3] How likely are each of these benefit and harms to happen to me?). Both groups received the questions prior to meeting with their surgeon. We used the Perceived Involvement in Care Scale (PICS), a validated instrument designed to evaluate patient participation in decision-making, as our primary outcome. The maximum PICS score is 13, and a higher score indicates higher perceived involvement. One hundred twenty-six patients participated in the study, with 63 patients in the QPL group and 63 patients in the AskShareKnow group. The demographic characteristics were similar in the 2 groups. The mean AskShareKnow group PICS score was 8.3 ± 2.2 and the mean QPL PICS score was 7.5 ± 2.8, which was not deemed clinically significant. The QPLs do not increase perceived involvement in care in patients with hand conditions compared with providing patients with 3 generic questions. Various approaches have been evaluated to help improve patient involvement in their care. In hand surgery, 3 generic questions were no different than a lengthy QPL with respect to patient involvement in their care.
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