Optimizing of a question prompt list to improve communication about the heart failure trajectory in patients, families, and health care professionals

Abstract

Background The aim of this study was to optimize a Question Prompt List which is designed to improve communication about the heart failure trajectory among patients, family members, and health care professionals. Methods Data were collected in a two-round Delphi survey and a cross-sectional survey, including patients with heart failure, their family members, and health care professionals working in heart failure care in Sweden and the Netherlands. Acceptability for and demand of the Question Prompt List were assessed. Results A total of 96 patients, 63 family members and 26 health care professionals participated in the study. Regarding acceptability, most of the original questions were found to be relevant by the participants for inclusion in the Question Prompt List but some cultural differences exist, which resulted in two versions of the list: a Swedish version including 33 questions and a Dutch version including 38 questions. Concerning demand, participants reported that they were interested in discussing the questions in the revised Question Prompt List with a physician or a nurse. Few patients and family members reported that they were worried by the questions in the Question Prompt List and hence did not want to discuss the questions. Conclusions This Question Prompt List has successfully been adapted into a Swedish version and a Dutch version and includes questions about the HF trajectory which patients, their families, and health care professionals perceived to be relevant for discussion in clinical practice. Overall, patients and family members were not worried about the content in the Question Prompt List and if used in accordance with patients’ and family members’ preferences, the Question Prompt List can help to improve communication about the heart failure trajectory.

Communication about Prognosis and End-of-Life in Heart Failure Care and Experiences Using a Heart Failure Question Prompt List

“…This paper provided further insight into the challenges health care professionals experience in discussing the HF trajectory, including prognosis and end-of-life in HF care. We also found that using a communication tool such as a QPL was perceived by health care professionals as promising and useful, which also was supported by our previous research [2,13]. A recent publication described the experiences with a pre-visit QPL to determine the educational needs of patients with HF and their family members.…”

Palliative Care in Heart Failure: An Integrative Review of Nurse Practice

“…The approach in the control of physical symptoms was the category most frequently addressed in the studies that make up this integrative review. [21][22][23]25,[27][28][29][30][31][32] For the relief of symptoms, it is necessary first to recognize them and understand how they affect the patient's routine. To make this assessment, one can make use of symptom assessment instruments, such as the Edmonton Symptom Assessment Scale (ESAS).…”

“…However, articulating this dimension with the integral approach and family orientation heightens the promotion of better quality of life while dealing with the disease. 21,[25][26][27][28][29][30][31][32]34 Nurses' practices also included the creation of dialog spaces to listen to what patients and family members have to say, to actively listen to their fears, their anxieties, and to help them free themselves from these feelings that can cause anxiety and depression. Spiritual issues approaches are part of the care practices implemented by nurses during the longitudinal follow-up of people with HF in palliative care.…”

Palliativversorgung bei Herzinsuffizienz

“…Die am besten untersuchte Checkliste, die sogenannte Question Prompt List (QPL), enthält eine Reihe von Fragen, die während einer Konsultation verwendet werden können, um sicherzustellen, dass schwierige Themen in die Diskussion zwischen Patient*in, Familie, Betreuer*in und medizinischem Fachpersonal einbezogen werden [12]. Themenschwerpunkte umfassen u. a. den Einfluss der HF auf den Alltag, Unterstützungsmöglichkeiten bei Verschlechterung, HF am Lebensende, Fragen unter Einbezug der Angehörigen, Fragen für Patient*innen mit Schrittmacher/ICD (s. ▶ Tab.…”