Arborelius E, Timpka T
Department of Community Medicine, Faculty of Health Sciences, Sweden.
Med Teach. 1990;12(2):197-208. doi: 10.3109/01421599009006697.
The aim of this study is to describe a two-step video method, where patients and physicians (on different occasions) comment on the recorded consultations, and to evaluate the method regarding the kind of information received and the influence of the video-camera on patients' and physicians' behaviour. We chose to depart from a phenomenological method introduced by Frankel and Beckman. Their method was modified with regard to the review procedure; the instructions, for example, were changed. Forty-six consultations were videotaped in four primary health care centres. Twelve general practitioners and 46 patients participated. Only a few patients (4) commented without any substantial content or in a completely neutral way. The remaining patients, and all the physicians, gave nuanced descriptions of their experiences during the consultations. Few (1/5) comments dealt with the videotaping itself; e.g. explanations to the research personnel and other irrelevant issues. The influence of the video-camera seemed to be stronger for the physicians than for the patients, but the effects were only marginal. The conclusion is, that by this modified video-method the ability to obtain knowledge to help to understand/interpret the patient-physician relationship was increased. Nowadays video-recording is an established method in behavioural science. In a study about the patient-physician relationship, we plan to use a two-step method of video-recording as the basis for analysing the key factors in the communication. Thus, it is important first to study the possibilities of obtaining valid and reliable information with the method, and then to make a decision about advantages and disadvantages.
本研究的目的是描述一种两步视频法，即患者和医生（在不同场合）对录制的会诊进行评论，并就所获得的信息种类以及摄像机对患者和医生行为的影响对该方法进行评估。我们选择背离弗兰克尔和贝克曼引入的现象学方法。他们的方法在审查程序方面进行了修改；例如，说明发生了变化。在四个初级卫生保健中心对46次会诊进行了录像。12名全科医生和46名患者参与其中。只有少数患者（4名）的评论没有任何实质性内容或以完全中立的方式进行。其余患者以及所有医生都对他们在会诊期间的经历进行了细致入微的描述。很少有（1/5）评论涉及录像本身；例如，向研究人员的解释和其他无关问题。摄像机对医生的影响似乎比对患者更强，但影响仅为轻微。结论是，通过这种改进的视频方法，获取有助于理解/诠释医患关系的知识的能力得到了提高。如今，录像在行为科学中是一种既定的方法。在一项关于医患关系的研究中，我们计划使用一种两步录像法作为分析沟通关键因素的基础。因此，首先研究用该方法获取有效且可靠信息的可能性，然后再对其优缺点做出决策很重要。
