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陆军军医大学(第三军医大学)第一附属医院泌尿外科,重庆
李雪梅,E-mail:lixuemeiw@tmmu.edu.cn
收稿日期:2025-08-28,
修回日期:2025-09-07,
录用日期:2025-09-08,
纸质出版日期:2025-09-30
移动端阅览
刘佳,张祖莉,夏弦,等.良性前列腺增生老年患者术前沟通问题提示列表构建及其应用效果的随机对照研究[J].陆军军医大学学报,2025,47(18):2281-2288.DOI:10.16016/j.2097-0927.202508088.
LIU JIA,ZHANG ZULI,XIA XIAN,et al.Development and application of a preoperative communication question prompt list for older patients with benign prostatic hyperplasia: a randomized controlled study[J].J Army Med Univ,2025,47(18):2281-2288.DOI:10.16016/j.2097-0927.202508088.
刘佳,张祖莉,夏弦,等.良性前列腺增生老年患者术前沟通问题提示列表构建及其应用效果的随机对照研究[J].陆军军医大学学报,2025,47(18):2281-2288.DOI:10.16016/j.2097-0927.202508088. DOI:
LIU JIA,ZHANG ZULI,XIA XIAN,et al.Development and application of a preoperative communication question prompt list for older patients with benign prostatic hyperplasia: a randomized controlled study[J].J Army Med Univ,2025,47(18):2281-2288.DOI:10.16016/j.2097-0927.202508088. DOI:
目的
2
为良性前列腺增生(benign prostatic hyperplasia,BPH)老年患者构建术前沟通问题提示列表(Question prompt list,QPL),并评价其应用效果。
方法
2
采用随机对照研究设计方案,通过文献研究、课题组讨论及德尔菲专家函询法构建术前沟通QPL。采用便利抽样法,选取陆军军医大学第一附属医院泌尿外科住院的76例老年BPH手术患者为研究对象,采用随机数字表法分为对照组(
n
=38)和干预组(
n
=38)。对照组采用常规术前沟通方法,干预组在此基础上使用QPL辅助术前沟通。比较2组患者提问数量、沟通时间、信息回忆和沟通质量。
结果
2
两轮专家函询问卷回收率分别为94.44%,100%;专家权威系数分别为0.89,0.93;变异系数分别为0.05~0.22,0~0.11;肯德尔和谐系数分别为0.645(χ
2
=87.782,
P
<
0.001),0.733(χ
2
=74.789,
P
<
0.001)。最终的QPL由3个主题和7个问题组成。干预组术前沟通的提问数量显著高于对照组[(4.03±1.89)
vs
(2.11±1.27)个,
P
<
0.05],2组沟通时间无显著差异[(8.18±2.11)
vs
(7.67±1.72) min,
P
>
0.05]。出院前1天,干预组信息回忆评分显著优于对照组[(8.74±1.12)
vs
(6.49±1.68)分,
P
<
0.001]。同时,干预组沟通质量评分高于对照组[(60.06±6.25)
vs
(54.86±7.98)分,
P
<
0.05]。
结论
2
构建的BPH老年患者术前沟通QPL具有科学性和有效性,该工具既可增加BPH老年患者的提问数量,又能提高信息回忆及沟通质量。
Objective
2
To develop a preoperative question prompt list (QPL) for older patients with benign prostatic hyperplasia (BPH) and evaluate its effectiveness in application.
Methods
2
This trial adopted a randomized controlled design. The QPL was developed by literature review
expert discussions
and Delphi consultation. Convenience sampling was used to subject 76 older BPH inpatients treated in our department
and then they were randomly divided into control (routine communication
n
=38) and intervention (QPL-assisted communication
n
=38) groups. Number of the questions patient asking
communication duration
information recall
and communication quality were compared between the 2 groups.
Results
2
In the 2 rounds of expert consultation
the response rate of questionnaire was 94.44% and 100%
the authority coefficient was 0.89 and 0.93
the coefficient of variation was 0.05~0.22 and 0~0.11
and Kendall’s coefficients was 0.645 (
Chi-square
=87.782
P
<
0.001) and 0.733 (
Chi-square
=74.789
P
<
0.001)
respectively. The final QPL included 3 themes and 7 questions. The intervention group asked more questions (4.03±1.89
vs
2.11±1.27
P
<
0.05) but spent similar time for communication (8.18±2.11
vs
7.67±1.72 min
P
>
0.05). At 1 d before discharge
better information recall (8.74±1.12
vs
6.49±1.68
P
<
0.001) and communication quality (60.06±6.25
vs
54.86±7.98
P
<
0.05) were observed in the intervention group when compared with the control group.
Conclusion
2
Our developed preoperative communication QPL is of scientificalness and effectiveness for elderly BPH patients. This tool can not only encourage question-asking behavior
but also improve information recall and communication quality in the patients.
GBD 2019 Benign Prostatic Hyperplasia Collaborators . The global, regional, and national burden of benign prostatic hyperplasia in 204 countries and territories from 2000 to 2019: a systematic analysis for the Global Burden of Disease Study 2019 [J]. Lancet Healthy Longev , 2022 , 3 ( 11 ): e754 - e776 . DOI: 10.1016/S2666-7568(22)00213-6 http://dx.doi.org/10.1016/S2666-7568(22)00213-6 .
胡燕 , 王欣 , 陈宪艳 , 等 . 1990—2021年中国良性前列腺增生疾病负担分析 [J]. 医学新知 , 2024 , 34 ( 12 ): 1329 - 1336 . DOI: 10.12173/j.issn.1004-5511.202410016 http://dx.doi.org/10.12173/j.issn.1004-5511.202410016 .
HU Y , WANG X , CHEN X Y , et al . The analysis of disease burden of benign prostatic hyperplasia in China from 1990 to 2021 [J]. New Med , 2024 , 34 ( 12 ): 1329 - 1336 . DOI: 10.12173/j.issn.1004-5511.202410016 http://dx.doi.org/10.12173/j.issn.1004-5511.202410016 .
SANDHU J S , BIXLER B R , DAHM P , et al . Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA guideline amendment 2023 [J]. J Urol , 2024 , 211 ( 1 ): 11 - 19 . DOI: 10.1097/ju.00000000 00003698 http://dx.doi.org/10.1097/ju.0000000000003698 .
SHARKIYA S H . Quality communication can improve patient-centred health outcomes among older patients: a rapid review [J]. BMC Health Serv Res , 2023 , 23 ( 1 ): 886 . DOI: 10.1186/s12913-023-09869-8 http://dx.doi.org/10.1186/s12913-023-09869-8 .
Ron D , Gunn C M , Havidich J E , et al . Preoperative communication between anesthesia, surgery, and primary care providers for older surgical patients [J]. Jt Comm J Qual Patient Saf , 2024 , 50 ( 5 ): 326 - 337 . DOI: 10.1016/j.jcjq.2024.01.006 http://dx.doi.org/10.1016/j.jcjq.2024.01.006 .
ABRAHAM A G , HONG C , DEAL J A , et al . Are cognitive researchers ignoring their senses? The problem of sensory deficit in cognitive aging research [J]. J Am Geriatr Soc , 2023 , 71 ( 5 ): 1369 - 1377 . DOI: 10.1111/jgs.18229 http://dx.doi.org/10.1111/jgs.18229 .
SANSONI J E , GROOTEMAAT P , DUNCAN C . Question Prompt Lists in health consultations: a review [J]. Patient Educ Couns , 2015 , 98 ( 12 ): 1454 - 1464 . DOI: 10.1016/j.pec.2015.05.015 http://dx.doi.org/10.1016/j.pec.2015.05.015 .
王奕 , 葛静玲 , 王娟 . 问题提示列表在肿瘤医患沟通中应用的范围综述 [J]. 护理学报 , 2023 , 30 ( 16 ): 57 - 62 . DOI: 10.16460/j.issn1008-9969.2023.16.057 http://dx.doi.org/10.16460/j.issn1008-9969.2023.16.057 .
WANG Y , GE J L , WANG J . Application of question prompt list in oncology doctor-patient communication: a scoping review [J]. J Nurs China , 2023 , 30 ( 16 ): 57 - 62 . DOI: 10.16460/j.issn1008-9969.2023.16.057 http://dx.doi.org/10.16460/j.issn1008-9969.2023.16.057 .
WANG S J , HU W Y , CHANG Y C . Question prompt list intervention for patients with advanced cancer: a systematic review and meta-analysis [J]. Support Care Cancer , 2024 , 32 ( 4 ): 231 . DOI: 10.1007/s00520-024-08432-3 http://dx.doi.org/10.1007/s00520-024-08432-3 .
胡应兰 , 王秀红 , 常慧 , 等 . 老年终末期肾病患者参与治疗决策问题提示列表的构建 [J]. 护理学报 , 2024 , 31 ( 23 ): 28 - 33 . DOI: 10.16460/j.issn1008-9969.2024.23.028 http://dx.doi.org/10.16460/j.issn1008-9969.2024.23.028 .
HU Y L , WANG X H , CHANG H , et al . Construction of the prompt list of patients with end-stage renal disease participating in treatment decision-making at old age [J]. J Nurs China , 2024 , 31 ( 23 ): 28 - 33 . DOI: 10.16460/j.issn1008-9969.2024.23.028 http://dx.doi.org/10.16460/j.issn1008-9969.2024.23.028 .
EY J D , HERATH M B , REID J L , et al . Improving communication and patient information recall via a question prompt list: randomized clinical trial [J]. Br J Surg , 2023 , 110 ( 12 ): 1793 - 1799 . DOI: 10.1093/bjs/znad303 http://dx.doi.org/10.1093/bjs/znad303 .
MAKOUL G , KRUPAT E , CHANG C H . Measuring patient views of physician communication skills: development and testing of the Communication Assessment Tool [J]. Patient Educ Couns , 2007 , 67 ( 3 ): 333 - 342 . DOI: 10.1016/j.pec.2007.05.005 http://dx.doi.org/10.1016/j.pec.2007.05.005 .
国家统计局 . 中华人民共和国2023年国民经济和社会发展统计公报 [EB/OL]. ( 2024-02-29 ). https://www.stats.gov.cn/sj/zxfb/202402/t20240228_1947915.html https://www.stats.gov.cn/sj/zxfb/202402/t20240228_1947915.html .
National Bureau of Statistics . Statistical Communiqué of the People’s Republic of China on the 2023 National Economic and Social Development [EB/OL]. ( 2024-02-29 ). https://www.stats.gov.cn/sj/zxfb/202402/t20240228_1947915.html https://www.stats.gov.cn/sj/zxfb/202402/t20240228_1947915.html .
Dias P , Clerc D , da Rocha Rodrigues M G , et al . Impact of an operating room nurse preoperative dialogue on anxiety, satisfaction and early postoperative outcomes in patients undergoing major visceral surgery-a single center, open-label, randomized controlled trial [J]. J Clin Med , 2022 Mar 29 ; 11 ( 7 ): 1895 . DOI: 10.3390/jcm11071895 http://dx.doi.org/10.3390/jcm11071895 .
刘佳 , 李雪梅 , 陈晓梅 , 等 . 老年良性前列腺增生手术患者感知医患沟通质量现状及影响因素 [J]. 护理学杂志 , 2025 , 40 ( 3 ): 1 - 5 . DOI: 10.3870/j.issn.1001-4152.2025.03.001 http://dx.doi.org/10.3870/j.issn.1001-4152.2025.03.001 .
LIU J , LI X M , CHEN X M , et al . Perceived quality of patient-provider communication and its influencing factors among elderly benign prostatic hyperplasia patients undergoing surgery [J]. J Nurs Sci , 2025 , 40 ( 3 ): 1 - 5 . DOI: 10.3870/j.issn.1001-4152.2025.03.001 http://dx.doi.org/10.3870/j.issn.1001-4152.2025.03.001 .
ZIETLOW K E , WONG S , HEFLIN M T , et al . Geriatric preoperative optimization: a review [J]. Am J Med , 2022 , 135 ( 1 ): 39 - 48 . DOI: 10.1016/j.amjmed.2021.07.028 http://dx.doi.org/10.1016/j.amjmed.2021.07.028 .
SCHULTE-VIETING T , SIEGLE A , JUNG C , et al . Developing a question prompt list for the oncology setting: a scoping review [J]. Patient Educ Couns , 2022 , 105 ( 7 ): 1689 - 1702 . DOI: 10.1016/j.pec.2021.10.006 http://dx.doi.org/10.1016/j.pec.2021.10.006 .
LOCKE A . Putting the ‘teachable moment’ in context: a view from critical health psychology [J]. J Health Psychol , 2023 , 28 ( 1 ): 3 - 16 . DOI: 10.1177/13591053221101750 http://dx.doi.org/10.1177/13591053221101750 .
赵晓霜 , 张葆荣 , 张丹 , 等 . 儿童连续血液净化护理质量评价指标体系的构建 [J]. 中华护理杂志 , 2020 , 55 ( 09 ): 1366 - 71 . DOI: 10.3761/j.issn.0254-1769.2020.09.017 http://dx.doi.org/10.3761/j.issn.0254-1769.2020.09.017 .
ZHAO X X , ZHANG B R , ZHANG D , et al . Establishment of quality indicator system for nursing in pediatric continuous blood purification [J] Chin J Nur , 2020 , 55 ( 09 ): 1366 - 71 . DOI: 10.3761/j.issn.0254-1769.2020.09.017 http://dx.doi.org/10.3761/j.issn.0254-1769.2020.09.017
JIANG S H . Pathway linking patient-centered communication to emotional well-being: taking into account patient satisfaction and emotion management [J]. J Health Commun , 2017 , 22 ( 3 ): 234 - 242 . DOI: 10.1080/10810730. 2016.1276986 http://dx.doi.org/10.1080/10810730.2016.1276986 .
刘宇婷 , 贺苗 . 健康传播中老年群体数字鸿沟产生的伦理问题与对策研究 [J]. 中国医学伦理学 , 2024 , 37 ( 7 ): 807 - 812 . DOI: 10.12026/j.issn.1001-8565.2024.07.09 http://dx.doi.org/10.12026/j.issn.1001-8565.2024.07.09 .
LIU Y T , HE M . Research on ethical issues and countermeasures of the digital divide among the elderly group in health communication [J]. Chin Med Ethics , 2024 , 37 ( 7 ): 807 - 812 . DOI: 10.12026/j.issn.1001-8565.2024.07.09 http://dx.doi.org/10.12026/j.issn.1001-8565.2024.07.09 .
TOBIANO G , MANIAS E , THALIB L , et al . Older patient participation in discharge medication communication: an observational study [J]. BMJ Open , 2023 , 13 ( 3 ): e064750 . DOI: 10.1136/bmjopen-2022-064750 http://dx.doi.org/10.1136/bmjopen-2022-064750 .
SCHWARZE M L , BUFFINGTON A , TUCHOLKA J L , et al . Effectiveness of a question prompt list intervention for older patients considering major surgery: a multisite randomized clinical trial [J]. JAMA Surg , 2020 , 155 ( 1 ): 6 - 13 . DOI: 10.1001/jamasurg.2019.3778 http://dx.doi.org/10.1001/jamasurg.2019.3778 .
郭淼 , 吕利明 , 吕宏旭 , 等 . 问题提示列表在术前医患沟通中应用效果的系统评价 [J]. 军事护理 , 2024 , 41 ( 12 ): 91 - 94, 99 . DOI: 10.3969/j.issn.2097-1826.2024.12.023 http://dx.doi.org/10.3969/j.issn.2097-1826.2024.12.023 .
GUO M , LYU L M , LYU H X , et al . Application of question prompt list in preoperative doctor-patient communication: a systematic review [J]. Mil Nurs , 2024 , 41 ( 12 ): 91 - 94, 99 . DOI: 10.3969/j.issn.2097-1826.2024.12.023 http://dx.doi.org/10.3969/j.issn.2097-1826.2024.12.023 .
ŚWIĄTONIOWSKA-LONC N , POLAŃSKI J , TAŃSKI W , et al . Impact of satisfaction with physician-patient communication on self-care and adherence in patients with hypertension: cross-sectional study [J]. BMC Health Serv Res , 2020 , 20 ( 1 ): 1046 . DOI: 10.1186/s12913-020-05912-0 http://dx.doi.org/10.1186/s12913-020-05912-0 .
BRANDES K , LINN A J , BUTOW P N , et al . The characteristics and effectiveness of Question Prompt List interventions in oncology: a systematic review of the literature [J]. Psychooncology , 2015 , 24 ( 3 ): 245 - 252 . DOI: 10.1002/pon.3637 http://dx.doi.org/10.1002/pon.3637 .
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