• Meghan McDarby, Hannah I Silverstein, and Brian D Carpenter.
• Department of Psychiatry and Behavioral Sciences (M.M.), Memorial Sloan Kettering Cancer Center, New York, New York, USA; Department of Psychological and Brain Sciences (H.I.S., B.D.C.), Washington Univers... more ity in St. Louis, St. Louis, Missouri, USA. Electronic address: mcdarbym@mskcc.org. less
• J Pain Symptom Manage. 2023 Apr 1; 65 (4): 285295285-295.

ContextQuestion prompt lists (QPLs) promote participation during medical appointments, including in the context of serious illness care. However, no studies have used parameters of a theoretical framework to examine the effects of QPL use in outpatient palliative care.ObjectivesThe current pilot randomized controlled trial evaluated use of a 25-question QPL during initial outpatient palliative care appointments. We applied tenets of Self-Efficacy Theory to investigate how use of a QPL affected appointment participation and perceived self-efficacy.MethodsParticipants were patients and care partners attending the patient's first palliative care appointment. Participants either received a QPL before the appointment (n = 29 appointments) or usual care (n = 30 appointments). Audio recordings of appointments were coded for total questions asked. Participants reported perceived self-efficacy in question asking pre- and postappointment. Analysis of variance was used to compare appointment participation between study conditions, and a linear mixed effects model was used to compare changes in ratings of perceived self-efficacy.ResultsParticipants who received the QPL did not ask significantly more questions compared to participants in usual-care appointments. There was a main effect of time on self-efficacy in question asking, such that self-efficacy increased from pre- to postappointment, but there was no effect of the intervention.ConclusionDespite their promise in previous studies, results of the current study suggest that QPLs may lack potency to shift patient and care partner question asking in palliative care appointments, and that other mechanisms outlined in Self-Efficacy Theory may characterize the relation between question asking and self-efficacy.Copyright © 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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