Integrating a Question Prompt List on an Inpatient Oncology Unit to Increase Prognostic Awareness

McLawhorn, Vicki; Vess, Joy; Dumas, Bonnie P.

doi:10.1188/16.cjon.385-390

Cited by 9 publications

(12 citation statements)

References 21 publications

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“…An increase in do not resuscitate (DNR) orders and hospice referrals was seen with this intervention. 17 Giving patients an instructive prompt and control over which prognostic questions to ask has the added benefit of giving them a sense of agency that is invaluable in their care.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of the Surprise Question on an Inpatient Oncology Service

Singh

Rodríguez

Lee

et al. 2018

Am J Hosp Palliat Care

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Regular discussion of prognosis of patients with cancer in an inpatient medical setting did not increase referrals to inpatient or outpatient palliative care or hospice. Increased clinical experience impacted hospital medicine providers and bedside nurses' estimation of prognosis differently than oncology providers. Medical oncologists were significantly more optimistic than hospital medicine providers.

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Section: Discussionmentioning

confidence: 99%

Usefulness of the Surprise Question on an Inpatient Oncology Service

Singh

Rodríguez

Lee

et al. 2018

Am J Hosp Palliat Care

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“…In most studies, patients reported the QPL to be useful, such that it could be beneficial for the caregivers to engage in question‐asking, 31,32 it was a good communication tool which organized and prompted patients to ask questions during the consultation, 38,42 helped patients address critical questions related to end‐of‐life, and reduced the burden of comprehending excessive information 32,43 . Similarly, McLawhorn et al 44 reported that the use of QPL increased the number of do‐not‐resuscitate orders and hospice referrals. During the consultation, it was observed that patients using the QPL did ask more questions, 31 were able to address important concerns they had, 45 and engaged in a meaningful discussion with their physician, 27,29 and the time taken for the medical consultation was not impacted 29,31 .…”

Section: Methodsmentioning

confidence: 99%

The Question‐prompt list (QPL): Why it is needed in the Indian oncology setting?

et al. 2020

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Background In India, caregivers are an integral part of the illness experience, especially in cancer, to the extent that they can become proxy decision‐makers for the patient. Further, owing to acute resource constraints in the Indian healthcare system, it may be difficult for oncologists to assess and elicit questions from each patient/caregiver. Consequently, there is a need to address these unique aspects of oncology care in India to improve patient outcomes and understanding of their illness and treatment. This can be achieved through a Question Prompt List (QPL), a checklist used by care recipients during medical consultations. Recent Findings This narrative review will first introduce research on the development and effectiveness of the QPL, and then it will highlight current gaps in oncology care in India and explore how the QPL may aid in closing these gaps. A literature search of the empirical research focused on the development, feasibility and acceptability of the QPL in oncology settings was conducted. The final review included 40 articles pertaining to QPL research. Additionally, psycho‐oncology research in India centered on information needs and experiences was reviewed. Current Indian psycho‐oncology research reports patients' want to be actively involved in their cancer care and a need for more illness information. However, a high demand on physicians' resources and the family caregivers' interference can be barriers to meeting patients' information/communication needs. International research demonstrates that a QPL helps structure and decrease consultation time, improves patient satisfaction with care, and improves the quality of communication during medical encounters. Conclusion QPLs for Indian patients and caregivers may focus on the scope of medical consultations to address patient needs while influencing the course and content of the patient‐caregiver‐physician interactions. Further, it can address the resource constraints in Indian oncology care settings, thus reducing the physician's burden.

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“…Given these issues identified that were associated with the Iranian women's making decisions about breast cancer treatment, we asked the healthcare team to identify potential questions that could be added to the QPL to enable patients to participate in shared decision-making. Existing evidence and other QPLs were considered for developing the QPLs (chemotherapy-related QPL and radiotherapyrelated QPL) to be used in the proposed study (18,(20)(21)(22)).…”

Section: Interventionmentioning

confidence: 99%

The Effect of Using the Question Prompt List on Shared Decision Making, Self-Efficacy in Decision Making, and Preferences for Participation Among Women with Breast Cancer: A Study Protocol

et al. 2020

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Background: There is increasing awareness that patients with cancer desire information as well as strategies to support their capacity to actively participate in informed decision-making. This study will evaluate outcomes of using a question prompt list (QPL) on shared decision making (SDM), decision-making self-efficacy, and preferences for participation among Iranian women with breast cancer, who are referred to a Tehran Comprehensive Cancer Center. Methods: This research will utilize a randomized controlled trial. The research population is patients with breast cancer, who are referred to the Oncology Radiotherapy Unit, Imam Khomeini Hospital, Tehran following tumor resection. After completing baseline surveys (demographics and health survey, decision self-efficacy scale, and control preferences scale), participants will be randomized into either a control or a treatment group based on block design. The treatment group will receive routine care along with the QPL that provides information on decision-making relative to treatment options (chemotherapy, radiotherapy, or both treatments) following meeting their oncologist. They will be trained to use the QPL which they will use to ask questions about their treatment choices when meeting with their physician or through computer-mediated modalities such as WhatsApp or other social messengers. These patients will have the opportunity to think about the treatment options and will be referred for medical treatment following their decision. The control group will receive routine care (physician discussion and receipt of treatment information). Following decision-making regarding treatment, the questionnaires will be administered (9-item SDM questionnaire, decision self-efficacy scale, and control preferences scale). Data will be analyzed using SPSS 16. Discussion: The current study will provide experimental evidence for the efficiency or lack of intervention that has the potential to improve shared decision-making outcomes, a better understanding of personal preferences related to decision-making and self-efficacy in medical decision-making for Iranian patients with breast cancer.

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Integrating a Question Prompt List on an Inpatient Oncology Unit to Increase Prognostic Awareness

Abstract: An increase was seen in the percentage of patients with active DNR orders and in hospice referrals after a discussion aid was included in admission packets.

Cited by 9 publications

References 21 publications

Usefulness of the Surprise Question on an Inpatient Oncology Service

Usefulness of the Surprise Question on an Inpatient Oncology Service

The Question‐prompt list (QPL): Why it is needed in the Indian oncology setting?

The Effect of Using the Question Prompt List on Shared Decision Making, Self-Efficacy in Decision Making, and Preferences for Participation Among Women with Breast Cancer: A Study Protocol

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