[The Effects of the Question Prompt List on Usefulness, Satisfaction and Anxiety in Patients With Terminal Cancer: A Meta-Analysis].

Abstract

Background: Difficulties and anxiety caused by poor communication between patients with terminal cancer and their caregivers and medical teams are common in clinical practice. This may lead to uncertainty and fear of treatment, affecting the progress of treatment and achievement of hospice-care goals. The results of prior research indicate that using a question prompt list to promote shared decision-making can improve communication between medical care providers and patients.

Purpose: This study was developed to explore the effectiveness of using question prompt lists in communications with terminal cancer patients and their families in clinical settings in Taiwan.

Methods: A systematic review of the literature using a meta-analysis research design was conducted in this study. Cochrane Risk of Bias Tool 2 was used to assess literature quality. The selected keywords were used to search six databases, including the English-language PubMed, Cochrane Library, Embase, EBSCOhost, and MEDLINE databases and the Chinese-language Airiti Library database. RevMen 5.4 software (the latest version released by the Nordic Cochrane Center in September 2020) was used for data analysis.

Results: Applying the question prompt list was found to significantly increase the number of questions asked (MD = 2.45, p = .01) and the usefulness (SMD = 0.25, p = .02). However, no significant changes in consultation time (MD = 4.49, p = .11), satisfaction (MD = 0.08, p = .91), or anxiety (SMD = 0.06, p = .62) were found.

Conclusions / implications for practice: The results support that simplifying and focusing the topics of each chapter and theme of the question prompt list based on time of use may allow the list to be used effectively in combination with family meetings in clinical practice and to be focused based on patient, caregiver, and family needs to facilitate more-productive discussions. This will allow meetings to better facilitate therapeutic relationships and patient and caregiver participation in treatment plans. An external communication coach may be added in the future to help patients and caregivers clarify needs and concerns and improve the effectiveness of consultations. As questioning skills are important to empowering patients, a question prompt list for patients with terminal cancer should be developed. The results of this study may be used to guide the practice of healthcare providers and referenced in caregiver in-service education.