Assessing the need for a question prompt list that encourages end-of-life discussions between patients with advanced cancer and their physicians: A focus group interview study

Objective Early integration of palliative and cancer care improves the quality of life and is facilitated by discussions about the end of life after cessation of active cancer treatment between patients with advanced cancer and their physicians. However, both patients and physicians find end-of-life discussions challenging. The aim of this study was to assess the need for a question prompt list (QPL) that encourages end-of-life discussions between patients with advanced cancer and their physicians. Methods Focus group interviews (FGIs) were conducted with 18 participants comprising 5 pancreatic cancer patients, 3 family caregivers, 4 bereaved family members, and 6 physicians. Three themes were discussed: question items that should be included in the QPL that encourages end-of-life discussions with patients, family caregivers, and physicians after cessation of active cancer treatment; when the QPL should be provided; and who should provide the QPL. Each interview was audio-recorded, and content analysis was performed. Results The following 9 categories, with 57 question items, emerged from the FGIs: (1) preparing for the end of life, (2) treatment decision-making, (3) current and future quality of life, (4) current and future symptom management, (5) information on the transition to palliative care services, (6) coping with cancer, (7) caregivers’ role, (8) psychological care, and (9) continuity of cancer care. Participants felt that the physician in charge of the patient's care and other medical staff should provide the QPL early during active cancer treatment. Significance of results Data were collected to develop a QPL that encourages end-of-life discussions between patients with advanced cancer and their physicians.

Impact of using question prompt list on shared decision making in the cancer patient: A systematic review

Background & Aim: Shared decision making belongs to the continuum between the two decision-making paradigms of the paternalistic perspective and the client’s complete independence. Various interventions, including the Question Prompt List have been developed to facilitate patients’ participation in counseling. This study aims to investigate the effects of question prompt list on shared decision making among cancer patients. Methods & Materials: For this study, the researchers performed a systematic review of the manuscripts available in Embase, PubMed, Scopus, and Web of Science databases which were published until January 2021. And then, the eligible studies investigating the effect of question prompt list on shared decision making were included in the study. The quality of the studies was assessed using the Cochrane risk of bias tool. Results: Two eligible papers were included in the study, and it was reported that question prompt list was provided before the patients’ consultation with the physician. Both studies have used OPTION 12 to measure shared decision making. The two articles reported that patient communication aid and question prompt list had no significant effect on improving shared decision making through OPTION 12. Conclusion: The findings of this systematic review could not confirm the impact of using question prompt list on shared decision making. more preliminary studies are needed to answer the question expressed by this systematic review study.

Developing Country-Specific Question Prompt Lists About Dementia Palliative Care for Family Caregivers

We aimed to develop question prompt lists for family caregivers of nursing home residents with advanced dementia to augment advance care planning conversations. In the context of a joint European-Canadian study, we used standardized nominal group methods to create country-specific lists of questions. (Bereaved) family caregivers of persons with dementia read an information booklet about end-of-life care for people with dementia, and generated questions to ask healthcare professionals. They also marked the most important questions from pre-selected questions from other lists. In the Netherlands, 20 participants contributed to a question prompt list of 24 questions that gravitated towards questions about terminating life and the responsibilities of physicians and family involved in decision making. In Canada, 4 participants came up with a question prompt list of 15 questions, related mostly to staff-family communication, with some the same as selected in the Netherlands. Data from the other countries will be presented too.