Nelson Eve-Lynn, Spaulding Ryan
Center For TeleMedicine and TeleHealth, Kansas University Medical Center, Kansas City, USA.
J Telemed Telecare. 2005;11 Suppl 1:105-7. doi: 10.1258/1357633054462010.
Four specialists (a child psychiatrist, an oncologist, a cardiologist and a rheumatologist) conducted telemedicine clinics using videoconferencing at a bandwidth of 128-384 kbit/s. The consultations were videorecorded. The coded interactions from the first two patients recruited from each of the four telemedicine clinics were analysed. Tapes were coded by two raters. We adapted the Roter interaction analysis system (RIAS) for the telemedicine context. Utterances were coded into socio-emotional and task-focused categories. There were 1055 utterances in total. Providers generated significantly more utterances across categories than patients. In the patient-provider interactions, only 2% of the total utterances related to the technology. The predominance of socio-emotional utterances compared with task-focused utterances for providers was contrary to our expectations. Further studies are required to establish the reliability of the adapted RIAS measure and to increase understanding of telemedicine communication patterns.
四位专家（一位儿童精神科医生、一位肿瘤学家、一位心脏病专家和一位风湿病专家）使用带宽为128 - 384 kbit/s的视频会议开展远程医疗门诊。会诊过程进行了录像。对从四个远程医疗门诊中招募的前两名患者的编码互动进行了分析。录像带由两名评分者进行编码。我们针对远程医疗环境对罗特互动分析系统（RIAS）进行了调整。话语被编码为社会情感和以任务为重点的类别。总共有1055条话语。与患者相比，提供者在各个类别中产生的话语明显更多。在医患互动中，与技术相关的话语仅占总话语的2%。提供者社会情感话语相对于以任务为重点的话语的主导地位与我们的预期相反。需要进一步研究以确定调整后的RIAS测量方法的可靠性，并增进对远程医疗沟通模式的理解。
