就醫提問單：促進醫病溝通的工具

Question Prompt Lists: A Tool for Improving Patient-Physician Communication

提升有效的醫病溝通是醫療場域的重要課題。就醫提問單(Question Prompt List, QPL)是一種簡便、個別化且低成本的工具，目的在賦權病人主動參與並有助醫病溝通的聚焦。其形式常為列有許多結構性問題的清單，這些問題是病人在就醫時可能向醫師發問的問題。QPL的學理基礎可溯源自病人增能賦權及健康識能。累積的實證已顯示QPL對病人及醫師的溝通行為皆有正向效果，在病人端，QPL可提升病人的主動參與，包括問較多問題、減低焦慮感、增加衛教資訊回憶量等；在醫師端則可促使醫師提供更多的衛教資訊，從而提高病人滿意度。台灣未來推展QPL的成功要素，應包括研發充足且可得性高的QPL、強化醫療人員的訓練與裝備、提高病人對QPL的認識，以及臨床實務的彈性調整。

 

In virtually every health care setting, improving patient-physician communication remains an important issue, and a question prompt list (QPL) as a simple, individualized, and inexpensive tool can be used to expedite active patient participation and to render the patient-physician communication more focused for more effective medical consultation. A QPL often consists of a structured list of questions which patients may wish to ask their physicians about illness and treatment. With its theoretical basis built on theories about patient empowerment and health literacy, QPL has increasingly reported in the literature positive effects on improving both patients’ and physicians’ communication behaviors as it helps encourage patients to ask more questions regarding their health care, reduce anxiety about consultation, and enhance greater health information recall. QPL has further been shown to improve the quantity of information provided by physicians during consultation, thereby boosting patients’ satisfaction with consultation. Key components of successful implementation of QPL in the future in Taiwan should include developing sufficient and accessible evidence-based QPLs, training health professionals, increasing patients’ awareness, and making necessary adjustments to render clinical procedures more flexible.