Date of Award

Spring 5-15-2022

Author's School

Graduate School of Arts and Sciences

Author's Department

Psychology

Degree Name

Doctor of Philosophy (PhD)

Degree Type

Dissertation

Abstract

Question prompt lists (QPLs) promote patient and care partner participation during medical appointments. The current study evaluated use of a 25-question QPL during initial outpatient palliative care appointments. I applied tenets of Social Cognitive Theory to investigate the relation between appointment participation, state anxiety, and perceived self-efficacy in the context of a QPL intervention. Participants were patients and care partners attending the patient’s first outpatient palliative care appointment at an academic hospital. Participants were randomly assigned to receive the QPL before the appointment (n = 29 appointments) or to receive usual care (n = 30 appointments). Audio recordings of appointments were transcribed and coded for total questions asked and assertions made. Participants also self-reported state anxiety, perceived self-efficacy in question asking, and perceived self-efficacy in getting health care information at pre- and post-appointment. On average, participants in QPL appointments did not ask significantly more questions or make significantly more assertions compared to participants in usual-care appointments. On average, participants reported a decrease in state anxiety from pre- to post-appointment, but there was no interaction effect of time and condition. There was also a main effect of time on self-efficacy in question asking, such that self-efficacy increased from pre- to post-appointment, but there was no interaction effect of time and condition. Despite their promise in previous studies, my results suggest QPLs may lack potency to shift certain types of participation, at least in palliative care appointments, and that other mechanisms of Social Cognitive Theory may better characterize the relation between question asking, state anxiety, and perceived self-efficacy.

Language

English (en)

Chair and Committee

Brian D. Carpenter

Committee Members

Brian D. Carpenter

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