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首页> 外文期刊>Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer >Physician endorsement alone may not enhance question-asking by advanced cancer patients during consultations about palliative care
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Physician endorsement alone may not enhance question-asking by advanced cancer patients during consultations about palliative care

机译：仅医生的认可可能不会增加晚期癌症患者在姑息治疗咨询期间的提问

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Purpose This study aimed to explore the effect of physician endorsement of question-asking on advanced cancer patients' question-asking behaviour during consultations about palliative care and to explore other potential predictors of patient question-asking. Methods Data were obtained from 80 control group patients from a randomised controlled trial of standard palliative care (PC) consultation (control group) versus provision of a question prompt list (QPL) before the consultation. Consecutive eligible patients with advanced cancer referred to 15 PC physicians from nine Australian PC centres participated. Baseline measures were obtained from patients; consultations were audiotaped, transcribed and analysed by blinded coders; and physicians estimated the patients' survival. Results Endorsement of question-asking by the physician was not related to the number of patient questions. Patients with the highest anxiety levels asked 3.5 times as many questions as those with least anxiety (incidence rate ratio (IRR)=3.54, 95% confidence interval (CI) 1.90-6.59, P=0.001). After allowing for the effect of anxiety, patients with an estimated survival of >12 weeks asked 76% more questions (IRR=1.76, 95% CI 1.03-3.00, P=0.04), whereas age, sex, educational background, occupation, information and involvement preferences and presence of a caregiver were not related to patient question-asking behaviour. Conclusion Physician endorsement of question-asking alone does not appear to increase questions by advanced cancer patients during consultations about PC. Additional resources such as QPLs may be needed to facilitate patient question-asking.
机译：目的这项研究旨在探讨医师支持提问对晚期癌症患者在姑息治疗咨询期间的提问行为的影响，并探讨患者提问的其他潜在预测因素。方法数据来自80名对照组患者，这些患者来自标准姑息治疗（PC）咨询（对照组）与咨询前提供问题提示列表（QPL）的随机对照试验。连续的符合条件的晚期癌症患者转介了来自澳大利亚9个PC中心的15位PC医师参加。从患者获得基线测量;盲人编码者对录音进行了录音，转录和分析;医生估计了病人的生存率。结果医师对提问的认可与患者提问的数量无关。焦虑水平最高的患者提出的问题比焦虑程度最低的患者多3.5倍（发生率（IRR）= 3.54，95％置信区间（CI）1.90-6.59，P = 0.001）。在考虑到焦虑的影响后，估计生存期大于12周的患者又提出了76％的问题（IRR = 1.76，95％CI 1.03-3.00，P = 0.04），而年龄，性别，教育背景，职业，信息参与偏好和看护人的存在与患者提问行为无关。结论医师对问诊的认可似乎并未增加晚期癌症患者在PC咨询过程中提出的问题。可能需要其他资源（例如QPL）来促进患者提问。

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