Mary Joanne Verhoef

Chapter 7 150 Patients and family considered the possibility to indicate which topic or question to discuss, before, during and after the consultation, convenient. “I also indicated that by ticking the boxes. I like that.” (patient 5) They said that the QPL supported asking specific questions during the consultation. During consultations, the QPL was used to gather practical information about specific topics and to make notes. After the consultation, patients sometimes used the QPL as a reminder to discuss some topics later, or re-used it in consultations with other clinicians involved, such as the general practitioner or medical oncologist. Usefulness of the QPL among non-specialist clinicians Clinicians hypothesised that the QPL could be useful for them as an overview of information needs patients and family may have, and as a manual with topics relevant to palliative care conversations. They thought that it would help them focus more on patients’ and families’ needs. “It [the QPL] requires more depth, but I think that is something the clinician has to look for. (…) I really see this as a helpful tool to support the conversation.” (clinician 14) They thought that the QPL could be used to check whether all relevant topics had been covered. “I think it is a fantastic reminder, but actually even more for the physician than for the patient.” (clinician 5) Especially topics regarding the future were considered important: “I think especially the future, indeed [is a topic that often emerges in conversations about palliative care]. (…) I think that that is something patients primarily want clarity about.” (clinician 3) Some clinicians indicated that the QPL could be supportive as it listed topics they used to explain ‘future scenarios’ to patients and family: “We always try to list every possible scenario. Apart from the symptoms. (…) And then we try to go through them, and we try to make a plan.” (clinician 15)

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