Patient participation in the cancer consultation: evaluation of a question prompt sheet.

BACKGROUND Active participation and asking questions are important ways in which patients can ensure they understand what the doctor has said. This study evaluated a question prompt sheet designed to encourage patients to ask questions in the cancer consultation. PATIENTS AND METHODS Patients (n = 142) were randomised to receive (i) a question prompt sheet or (ii) a general sheet informing patients of services available through the regional Cancer Council. Recall of information was assessed in a structured interview 4-20 days after the consultation. Questionnaires to assess patient satisfaction and adjustment to cancer were sent by mail. RESULTS The question prompt sheet had a significant effect in one content area: prognosis. Thirty-five percent of patients who received the question handout asked questions about prognosis compared to 16% of those receiving the information handout. The prompt sheet did not increase the mean number of questions asked overall. Age, in/out-patient status, gender and involvement preference were predictive of both number and duration of patient questions. CONCLUSIONS A question prompt sheet has a limited but important effect on patient question asking behaviour in the cancer consultation.

[1]  B. Korsch,et al.  Gaps in doctor-patient communication. 1. Doctor-patient interaction and patient satisfaction. , 1968, Pediatrics.

[2]  M. Lorr,et al.  Manual for the Profile of Mood States , 1971 .

[3]  Eliot Freidson,et al.  Client Control and Medical Practice , 1960, American Journal of Sociology.

[4]  J Bennett,et al.  Communicating with patients. , 1992, BMJ.

[5]  G. Reader,et al.  Physicians' views on the level of medical information among patients. , 1957, American journal of public health and the nation's health.

[6]  D. Buller,et al.  Physicians' communication style and patient satisfaction. , 1987, Journal of health and social behavior.

[7]  D. Roter Patient Participation in the Patient-Provider Interaction: The Effects of Patient Question Asking on the Quality of Interaction, Satisfaction and Compliance* , 1977, Health education monographs.

[8]  D. Gibson,et al.  The informative process in private medical consultations: a preliminary investigation. , 1978, Social science & medicine.

[9]  C. Spielberger,et al.  Manual for the State-Trait Anxiety Inventory , 1970 .

[10]  J J Taylor,et al.  General information tapes inhibit recall of the cancer consultation. , 1993, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[11]  B. Cassileth,et al.  Information and participation preferences among cancer patients. , 1980, Annals of internal medicine.

[12]  R. Bales Interaction process analysis , 1976 .

[13]  P. Butow,et al.  Cancer by another name: a randomized trial of the effects of euphemism and uncertainty in communicating with cancer patients. , 1993, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[14]  P. Butow,et al.  On the receiving end. IV: Validation of quality of life indicators. , 1991, Annals of oncology : official journal of the European Society for Medical Oncology.

[15]  D. Thomasma Beyond medical paternalism and patient autonomy: a model of physician conscience for the physician-patient relationship. , 1983, Annals of internal medicine.

[16]  D. Tritchler,et al.  Cancer Patients: Their Desire for Information and Participation in Treatment Decisions , 1989, Journal of the Royal Society of Medicine.

[17]  D. Roter Patient question asking in physician-patient interaction. , 1984, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[18]  S. Reiser Words as scalpels: transmitting evidence in the clinical dialogue. , 1980, Annals of internal medicine.

[19]  R. Snaith,et al.  The Hospital Anxiety and Depression Scale , 1983 .

[20]  O. Holsti Content Analysis for the Social Sciences and Humanities , 1969 .

[21]  Eliot R. Smith,et al.  Research methods in social relations , 1962 .

[22]  B. Korsch,et al.  Gaps in doctor-patient communication. Patients' response to medical advice. , 1969, The New England journal of medicine.

[23]  A McMurray,et al.  Measuring the quality of life of cancer patients: the Functional Living Index-Cancer: development and validation. , 1984, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.