Department of Primary Care and Public Health, Imperial College London, London, UK.
Patient Educ Couns. 2010 Oct;81(1):113-8. doi: 10.1016/j.pec.2010.01.005. Epub 2010 Feb 9.
This paper describes communication in the physical examination phases of telemedicine consultations.
Using the method of conversation analysis, we draw on 10 telemedicine consultations (five telecardiology and five televascular) between primary and tertiary care in the UK.
Physical examination is absent in telecardiology consultations. In televascular consultations the professionals try to compensate for the lack of physical proximity by getting involved in a form of collaboration that constitutes a novel environment for all. Separated from the patient by physical space, the specialist orchestrates the positioning of the patient, the camera and the primary care nurse's activity via the use of a video-link.
Telemedicine offers primary care nurses a unique opportunity to engage in active collaboration with hospital specialists. The nurses' examination skills are recruited because physical examination is conducted from distance and the specialist cannot touch the patient or see parts of the body with ease. We speculate that difficulties with the physical examination may have contributed to the relatively slow adoption of telemedicine.
The analysis reveals some new communication practices that participants in telemedicine are called to adopt. This can be used to inform training interventions that focus both on patient and professional.
本文描述了远程医疗咨询中体检阶段的交流。
我们采用会话分析的方法，对英国初级保健和三级保健之间的 10 次远程心脏病学和远程血管学咨询进行了研究。
远程心脏病学咨询中没有体检。在远程血管学咨询中，专业人员试图通过参与一种合作形式来弥补身体上的距离，这种合作形式对所有人来说都是一个新的环境。专科医生通过视频链接将自己与患者隔开，协调患者、摄像头和初级保健护士的活动位置。
远程医疗为初级保健护士提供了与医院专家进行积极合作的独特机会。由于体检是在远程进行的，专家无法轻易触摸患者或看到身体的某些部位，因此需要招募护士的体检技能。我们推测，体检方面的困难可能是远程医疗采用相对缓慢的原因之一。
分析揭示了远程医疗参与者需要采用的一些新的沟通实践。这可以用于为关注患者和专业人员的培训干预措施提供信息。
