Randomized trial of a question prompt list to increase patient active participation during interactions with black patients and their oncologists
Randomized trial of a question prompt list to increase patient active participation during interactions with black patients and their oncologists
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DOI：
10.1016/j.pec.2016.12.026
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发表时间：
2017-05-01
影响因子：
3.5
通讯作者：
Penner, Louis A.
中科院分区：
文献类型：
--
作者：
Eggly, Susan;Hamel, Lauren M.;Penner, Louis A.
目的：在种族不和谐的互动中，沟通质量往往很差，可能会导致种族待遇差异。我们评估了一种干预措施，旨在增加患者的积极参与和其他沟通相关的结果在黑人患者和非黑人oncologist.Methods之间的互动：参与者是18个非黑人医学肿瘤学家和114名黑人患者在两个癌症医院在底特律，密歇根州，美国。在诊所访问讨论治疗之前，患者被随机分配到常规护理或两种问题提示列表（QPL）格式之一：小册子（仅QPL）或小册子和沟通教练（QPL+教练）。对患者-肿瘤学家的互动进行视频记录。患者报告的干预，肿瘤科医生的沟通，在治疗决策中的作用，并在肿瘤科医生的信任的看法。观察员评估的互动长度，病人的积极参与，和肿瘤学家communication.Results：干预被视为积极的，并没有增加互动长度。仅QPL格式增加了患者的积极参与; QPL+教练格式降低了患者对肿瘤科医生沟通的看法。没有其他显着的影响被发现。结论：这QPL小册子是可以接受的，并增加患者积极参与种族不一致的肿瘤相互作用。未来的研究应该调查是否增加以医生为中心的干预措施可能会改善其他结果。实践的影响：这QPL小册子是可以接受的，可以提高患者积极参与种族不一致的肿瘤相互作用。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Objective: 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.Methods: 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.Results: 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.Conclusion: 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. Practice implications: This QPL booklet is acceptable and can improve patient active participation in racially-discordant oncology interactions. (C) 2016 Elsevier Ireland Ltd. All rights reserved.