Question prompt lists and caregiver question asking in pediatric specialty appointments: A randomized controlled trial.

Autor: Waltz M; Department of Social Medicine, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA. Electronic address: margaret_waltz@med.unc.edu., Yan H; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Cadigan RJ; Department of Social Medicine, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA., Canter C; Department of Anthropology, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA., Bain L; Parent/Advocate, Knightdale, NC, USA., Bensen JT; Department of Epidemiology, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA., Conway C; Parent/Advocate, Parent Advocates for Adult Children with Intellectual &/or Developmental Disabilities in NC, Chapel Hill, NC, USA., Haldeman-Englert C; Fullerton Genetics Center, Mission Health, Asheville, NC, USA., Farnan L; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA., M Foreman AK; Department of Genetics, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA., Grant TL; Department of Genetics, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA., Leach B; Parent/Advocate, Family Support Program, School of Social Work, UNC Chapel Hill, Chapel Hill, NC, USA., Lin FC; Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Mahla M; Department of Genetics, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA., O'Daniel JM; Department of Genetics, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA., O'Neill SC; Department of Oncology, Georgetown University, Washington, DC, USA., Smith G; Parent/Advocate, Holly Springs, NC, USA., Powell BC; Department of Genetics, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA., Berg JS; Department of Genetics, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA., Rini CM; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA.
Jazyk: angličtina
Zdroj: Patient education and counseling [Patient Educ Couns] 2023 Apr; Vol. 109, pp. 107620. Date of Electronic Publication: 2023 Jan 02.
DOI: 10.1016/j.pec.2022.107620
Abstrakt: Objective: Question prompt lists (QPLs) have been effective at increasing patient involvement and question asking in medical appointments, which is critical for shared decision making. We investigated whether pre-visit preparation (PVP), including a QPL, would increase question asking among caregivers of pediatric patients with undiagnosed, suspected genetic conditions.
Methods: Caregivers were randomized to receive the PVP before their appointment (n = 59) or not (control, n = 53). Appointments were audio-recorded. Transcripts were analyzed to determine questions asked.
Results: Caregivers in the PVP group asked more questions (Mean PVP = 4.36, SD PVP = 4.66 vs. Mean control = 2.83, SD control = 3.03, p = 0.045), including QPL questions (Mean PVP = 1.05, SD PVP = 1.39 vs. Mean control = 0.36, SD control = 0.81, p = 0.002). Caregivers whose child had insurance other than Medicaid in the PVP group asked more total and QPL questions than their counterparts in the control group (ps = 0.005 and 0.002); there was no intervention effect among caregivers of children with Medicaid or no insurance (ps = 0.775 and 0.166).
Conclusion: The PVP increased question asking but worked less effectively among traditionally underserved groups. Additional interventions, including provider-focused efforts, may be needed to promote engagement of underserved patients.
Practice Implications: Patient/family-focused interventions may not be beneficial for all populations. Providers should be aware of potential implicit and explicit biases and encourage question asking to promote patient/family engagement.
Competing Interests: Conflict of interest The authors declare no conflict of interest.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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