Jonathan C Yeh1, M Jennifer Cheng1, Christine H Chung1, Thomas J Smith2. 1. Johns Hopkins School of Medicine and Sidney Kimmel Comprehensive Cancer Center of Johns Hopkins Medical Institutions, Baltimore, MD. 2. Johns Hopkins School of Medicine and Sidney Kimmel Comprehensive Cancer Center of Johns Hopkins Medical Institutions, Baltimore, MD tsmit136@jhmi.edu.
Abstract
PURPOSE: Oncologists and patients often avoid discussing prognosis, treatment failure, and end-of-life planning. Thus, many patients still overestimate their prognosis and possibility of cure, impairing decision making. We piloted a question prompt list (QPL) covering these issues to determine whether it would affect patient anxiety and how it would be used and received by new oncology patients. MATERIALS AND METHODS: A one-page checklist of common questions surrounding cancer care, quality of life, and end of life was created from previous instruments. A total of 30 patients with advanced or metastatic head and neck cancer were recruited from outpatient clinics. Patients received the QPL before their initial consultation. Patient anxiety, satisfaction, and information/decision-making preferences were assessed using validated instruments. Patient opinions regarding the QPL were solicited through Likert-scale items. RESULTS: During their visit, 27 patients (90%) used the QPL, but notably, none shared it directly with their oncologist. Most participants felt that the QPL was relevant and helpful (90%) and recommended that more physicians use this sort of list (90%) while disagreeing that the QPL made them feel anxious (80%). Generally, participants were highly satisfied with the consultation, and their anxiety decreased during the visit (P < .005). CONCLUSION: A simple, one-page QPL addressing cancer treatment, prognosis, quality of life, and end-of-life issues was well received by new oncology patients and did not affect patient anxiety or physician workflow. Follow-up studies will determine whether use of the QPL increases knowledge, facilitates decision making, and improves advance-care planning.
PURPOSE: Oncologists and patients often avoid discussing prognosis, treatment failure, and end-of-life planning. Thus, many patients still overestimate their prognosis and possibility of cure, impairing decision making. We piloted a question prompt list (QPL) covering these issues to determine whether it would affect patientanxiety and how it would be used and received by new oncology patients. MATERIALS AND METHODS: A one-page checklist of common questions surrounding cancer care, quality of life, and end of life was created from previous instruments. A total of 30 patients with advanced or metastatic head and neck cancer were recruited from outpatient clinics. Patients received the QPL before their initial consultation. Patientanxiety, satisfaction, and information/decision-making preferences were assessed using validated instruments. Patient opinions regarding the QPL were solicited through Likert-scale items. RESULTS: During their visit, 27 patients (90%) used the QPL, but notably, none shared it directly with their oncologist. Most participants felt that the QPL was relevant and helpful (90%) and recommended that more physicians use this sort of list (90%) while disagreeing that the QPL made them feel anxious (80%). Generally, participants were highly satisfied with the consultation, and their anxiety decreased during the visit (P < .005). CONCLUSION: A simple, one-page QPL addressing cancer treatment, prognosis, quality of life, and end-of-life issues was well received by new oncology patients and did not affect patientanxiety or physician workflow. Follow-up studies will determine whether use of the QPL increases knowledge, facilitates decision making, and improves advance-care planning.
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