Promoting patient participation in the cancer consultation: evaluation of a prompt sheet and coaching in question asking

Active participation in the medical consultation has been demonstrated to b enefit aspects of patients' subsequent psychological well-being. We investi gated two interventions promoting patient question-asking behaviour. The fi rst was a question prompt sheet provided before the consultation, which was endorsed and worked through by the clinician. The second was a face to fac e coaching session exploring the benefits of, and barriers to, question-ask ing, followed by coaching in question-asking behaviour employing rehearsal techniques. Sixty patients with heterogeneous cancers, seeing two medical o ncologists for the first timer were randomly assigned to one of three group s: two intervention groups and one control group. Sociodemographic variable s and anxiety were assessed prior to the intervention which preceded the co nsultation, The consultations were audiotaped and subsequently analysed for question-asking behaviour. Anxiety was assessed again immediately followin g the consultation. Questionnaires to assess patient satisfaction, anxiety and psychological adjustment were sent by mail 2 weeks following the consul tation. Presentation and discussion of the prompt sheet significantly incre ased the total number of questions asked and the number of questions asked regarding tests and treatment. Coaching did not add significantly to the ef fects of the prompt sheet. Psychological outcomes were not different among the groups, We conclude that a question prompt sheet addressed by the docto r is a simple, inexpensive and effective means of promoting patient questio n asking in the cancer consultation.