Abstract
Context
Question prompt lists (QPLs) promote participation during medical appointments, including
in the context of serious illness care. However, no studies have used parameters of
a theoretical framework to examine the effects of QPL use in outpatient palliative
care.
Objectives
The current pilot randomized controlled trial evaluated use of a 25-question QPL during
initial outpatient palliative care appointments. We applied tenets of Self-Efficacy
Theory to investigate how use of a QPL affected appointment participation and perceived
self-efficacy.
Methods
Participants were patients and care partners attending the patient's first palliative
care appointment. Participants either received a QPL before the appointment (n = 29 appointments) or usual care (n = 30 appointments). Audio recordings of appointments were coded for total questions
asked. Participants reported perceived self-efficacy in question asking pre- and postappointment.
Analysis of variance was used to compare appointment participation between study conditions,
and a linear mixed effects model was used to compare changes in ratings of perceived
self-efficacy.
Results
Participants who received the QPL did not ask significantly more questions compared
to participants in usual-care appointments. There was a main effect of time on self-efficacy
in question asking, such that self-efficacy increased from pre- to postappointment,
but there was no effect of the intervention.
Conclusion
Despite their promise in previous studies, results of the current study suggest that
QPLs may lack potency to shift patient and care partner question asking in palliative
care appointments, and that other mechanisms outlined in Self-Efficacy Theory may
characterize the relation between question asking and self-efficacy.
Key Words
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Article info
Publication history
Published online: December 21, 2022
Accepted:
December 13,
2022
Identification
Copyright
© 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
