Demiris George, Edison Karen, Vijaykumar Santosh
Department of Health Management and Informatics, University of Missouri-Columbia, 324 Clark Hall, Columbia, MO 65211, USA.
Int J Med Inform. 2005 Oct;74(10):851-6. doi: 10.1016/j.ijmedinf.2005.03.018.
While there may be benefits that accrue to the use of telemedicine technology in patient care, such as decreased costs and improved access, it has yet to be determined how telemedicine impacts patients' ability to express themselves and accordingly, how it impacts health care providers' communication of instructions or expressions of empathy.
The aim of this study was to examine the effect of telemedicine technology on communication by comparing the style and content of communication between actual (i.e., face to face) and virtual (i.e., non-face to face, telemedical) dermatology visits. The hypothesis was that there is no difference in the content and style of communication between actual and virtual visits in dermatology.
Face-to-face and video-mediated dermatology sessions were observed and also audiotaped, timed and transcribed. A content analysis was performed.
Average duration of a face-to-face session was 11 min (S.D. 0.08) and of a telemedical session 9 min (S.D. 0.002). Small talk occurred in 20% of all face-to-face and 29.6% of all telemedical visits. Clinical assessment occurred in all sessions. Patient education occurred in 90% of face-to-face and 78% of telemedical visits. Other themes were also identified (e.g., discussion of treatment, promotion of compliance, psychosocial issues). In 14.8% of telemedical sessions technical issues were raised. Findings indicate that communication patterns in the two modes of care delivery are comparable.
虽然在患者护理中使用远程医疗技术可能会带来一些益处，比如降低成本和改善就医机会，但远程医疗如何影响患者表达自身的能力，以及相应地，它如何影响医疗服务提供者传达指示或表达同理心，目前尚未确定。
本研究的目的是通过比较实际（即面对面）和虚拟（即非面对面、远程医疗）皮肤科就诊之间的沟通方式和内容，来检验远程医疗技术对沟通的影响。假设是皮肤科实际就诊和虚拟就诊之间的沟通内容和方式没有差异。
观察并录制了面对面和视频介导的皮肤科诊疗过程，记录时间并进行转录，然后进行内容分析。
面对面诊疗的平均时长为11分钟（标准差0.08），远程医疗诊疗的平均时长为9分钟（标准差0.002）。20%的面对面诊疗和29.6%的远程医疗诊疗中出现了闲聊。所有诊疗过程都进行了临床评估。90%的面对面诊疗和78%的远程医疗诊疗中进行了患者教育。还确定了其他主题（如治疗讨论、促进依从性、心理社会问题）。在14.8%的远程医疗诊疗中出现了技术问题。研究结果表明，两种护理模式下的沟通模式具有可比性。
