Discussion
cancer, anxiety, Cancer
ONCOLOGY, CANCER, AIDS, CANCER
In this randomized clinical trial, patients perceived both the QPS and GIS as helpful when communicating with their physician, with no significant difference between groups. However, patients felt the QPS facilitated generation of new questions. They also had a better overall global view of the QPS, and after using both materials concurrently during a follow-up visit, patients preferred the QPS to the GIS for communicating with their physicians. Previous studies by our group have reported the perceived helpfulness of the QPS during patient-physician communication.The QPS did not increase patient anxiety during the clinical encounter. This should reassure health care practitioners who may be concerned that the QPS questions will be emotionally upsetting and negatively impact patients’ psychological outcomes. Several studies have examined the association between the use of a QPS and patient anxiety.We found that the QPS neither prolonged the duration of the visit nor increased the physician or patient speaking time. In fact, participants in the QPS group spoke less than did those in the GIS group, suggesting that the QPS may improve the efficiency of communication without prolonging clinical encounters. Previous studies by our group and others also observed no association of the QPS with consultation length.Although patients felt the QPS facilitated generation of new questions, it did not result in an increase in the number of questions asked. The goal with the use of a QPS is to empower patients to generate and ask essential questions that meet their information needs. The QPS may effectively improve communication quality without necessarily increasing the number of questions that patients ask. Patients may be able to ask their most meaningful questions rather than simply asking more questions. In that regard, patient self-report of the helpfulness of the material might be a highly reliable indicator of benefit from the information material. Further studies are needed to ascertain the best means of measuring the true utility of the QPS.Compared with previous findings,The reason why Black and Hispanic patients were more likely to perceive the information material as helpful is unclear, but it suggests that a written material that aids in patient communication might be particularly valued by members of racial and ethnic minority groups, including Black and Hispanic patients. In a different study, the QPS was found very acceptable by Black patients with cancer and effectively increased their active participation in racially discordant interactions.Major medical organizations, such as the National Cancer Institute, the National Academy of Medicine, and the American Society for Clinical Oncology, have alluded to the benefits of good communication in quality of care and emphasized the need for improved patient-physician communication among patients with advanced illnesses.