PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of brjcancerBJC HomepageBJC Advance online publicationBJC Current IssueSubmitting an article to BJCWeb feeds
 
Br J Cancer. 2001 November; 85(9): 1273–1279.
Published online 2001 September 1. doi:  10.1054/bjoc.2001.2073
PMCID: PMC2375236

Promoting patient participation and shortening cancer consultations: a randomised trial

Abstract

Patient participation in medical consultations has been demonstrated to benefit their subsequent psychological well being. Question asking is one way in which patients can be active. We investigated 2 means of promoting cancer patient question asking. One was the provision of a question prompt sheet to patients prior to their initial consultation with their oncologist. The second was the active endorsement and systematic review of the question prompt sheet by their oncologist. 318 patients with heterogeneous cancers, seeing one of 5 medical and 4 radiation oncologists for the first time, were randomised to either receive or not receive a question prompt sheet. Doctors were randomised to either proactively address or passively respond to the question prompt sheet in the subsequent consultation. Anxiety was assessed prior to the consultation. Consultations were audiotaped and content analysed. Anxiety was assessed again immediately following the consultation. Within the next 10 days patients completed questionnaires assessing information needs, anxiety and satisfaction and were given a structured telephone interview assessing information recall. Patients provided with a question prompt sheet asked more questions about prognosis compared with controls and oncologists gave significantly more prognostic information to these patients. Provision of the question prompt sheet prolonged consultations and increased patient anxiety; however, when oncologists specifically addressed the prompt sheet, anxiety levels were significantly reduced, consultation duration was decreased and recall was significantly improved. A patient question prompt sheet, used proactively by the doctor, is a powerful addition to the oncology consultation. © 2001 Cancer Research Campaign

Full Text

The Full Text of this article is available as a PDF (64K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Barry CA, Bradley CP, Britten N, Stevenson FA, Barber N. Patients' unvoiced agendas in general practice consultations: qualitative study. BMJ. 2000 May 6;320(7244):1246–1250. [PMC free article] [PubMed]
  • Blanchard CG, Labrecque MS, Ruckdeschel JC, Blanchard EB. Physician behaviors, patient perceptions, and patient characteristics as predictors of satisfaction of hospitalized adult cancer patients. Cancer. 1990 Jan 1;65(1):186–192. [PubMed]
  • Brody H. Autonomy revisited: progress in medical ethics: discussion paper. J R Soc Med. 1985 May;78(5):380–387. [PMC free article] [PubMed]
  • Brown R, Butow PN, Boyer MJ, Tattersall MH. Promoting patient participation in the cancer consultation: evaluation of a prompt sheet and coaching in question-asking. Br J Cancer. 1999 Apr;80(1-2):242–248. [PMC free article] [PubMed]
  • Butow PN, Dunn SM, Tattersall MH, Jones QJ. Patient participation in the cancer consultation: evaluation of a question prompt sheet. Ann Oncol. 1994 Mar;5(3):199–204. [PubMed]
  • Butow PN, Kazemi JN, Beeney LJ, Griffin AM, Dunn SM, Tattersall MH. When the diagnosis is cancer: patient communication experiences and preferences. Cancer. 1996 Jun 15;77(12):2630–2637. [PubMed]
  • Cassileth BR, Zupkis RV, Sutton-Smith K, March V. Information and participation preferences among cancer patients. Ann Intern Med. 1980 Jun;92(6):832–836. [PubMed]
  • Dunn SM, Butow PN, Tattersall MH, Jones QJ, Sheldon JS, Taylor JJ, Sumich MD. General information tapes inhibit recall of the cancer consultation. J Clin Oncol. 1993 Nov;11(11):2279–2285. [PubMed]
  • Gattellari M, Butow PN, Tattersall MH. Informed consent: what did the doctor say? Lancet. 1999 May 15;353(9165):1713–1713. [PubMed]
  • Kaplan SH, Greenfield S, Gandek B, Rogers WH, Ware JE., Jr Characteristics of physicians with participatory decision-making styles. Ann Intern Med. 1996 Mar 1;124(5):497–504. [PubMed]
  • Korsch BM, Gozzi EK, Francis V. Gaps in doctor-patient communication. 1. Doctor-patient interaction and patient satisfaction. Pediatrics. 1968 Nov;42(5):855–871. [PubMed]
  • Levinson W, Stiles WB, Inui TS, Engle R. Physician frustration in communicating with patients. Med Care. 1993 Apr;31(4):285–295. [PubMed]
  • Roter DL. Patient participation in the patient-provider interaction: the effects of patient question asking on the quality of interaction, satisfaction and compliance. Health Educ Monogr. 1977 Winter;5(4):281–315. [PubMed]
  • Smith CK, Polis E, Hadac RR. Characteristics of the initial medical interview associated with patient satisfaction and understanding. J Fam Pract. 1981 Feb;12(2):283–288. [PubMed]
  • Stiles WB, Putnam SM, Wolf MH, James SA. Interaction exchange structure and patient satisfaction with medical interviews. Med Care. 1979 Jun;17(6):667–681. [PubMed]
  • Street RL., Jr Information-giving in medical consultations: the influence of patients' communicative styles and personal characteristics. Soc Sci Med. 1991;32(5):541–548. [PubMed]
  • Sutherland HJ, Llewellyn-Thomas HA, Lockwood GA, Tritchler DL, Till JE. Cancer patients: their desire for information and participation in treatment decisions. J R Soc Med. 1989 May;82(5):260–263. [PMC free article] [PubMed]
  • Tattersall MH, Butow PN, Griffin AM, Dunn SM. The take-home message: patients prefer consultation audiotapes to summary letters. J Clin Oncol. 1994 Jun;12(6):1305–1311. [PubMed]
  • Wriglesworth JM, Williams JT. The construction of an objective test to measure patient satisfaction. Int J Nurs Stud. 1975;12(3):123–132. [PubMed]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK