从问卷到对话：一种改善 HIV 检测咨询的结构性干预措施。
From questionnaire to conversation: a structural intervention to improve HIV test counseling.
机构信息
UCSF Center for AIDS Prevention Studies, San Francisco, CA 94105, USA.
出版信息
Patient Educ Couns. 2010 Dec;81(3):468-75. doi: 10.1016/j.pec.2010.08.011.
OBJECTIVE
We describe the effects of structural intervention to enhance the quality of HIV test counseling interaction with men who have sex with men (MSM) in San Francisco.
METHODS
Audio recordings of 28 rapid HIV test sessions by seven counselors were collected in two phases: before and after implementation of a waiting room intervention prior to the session. The sessions were analyzed using sequence maps to visualize and compare the sequence and distribution of four activities: counseling, information delivery, data collection, and sample collection.
RESULTS
Prior to the intervention, counselors and clients often oriented to data collection about the client's past risk as if it were a survey. In sessions recorded after the intervention, questions about past risk were dispersed throughout the session and embedded within an elaborated discussion of the client's particular life circumstances.
CONCLUSION
Direct observation with the aid of sequence maps illuminates the ways that counselors and clients collaboratively orient to various tasks.
PRACTICE IMPLICATIONS
We demonstrated the feasibility of a structural intervention that improved the quality of both counseling and the accuracy of client risk data without requiring additional session time or counselor training.
目的
我们描述了结构干预对提高与男男性接触者（MSM）进行 HIV 检测咨询互动质量的影响，该干预措施在旧金山实施。
方法
在两个阶段收集了七名咨询师的 28 次快速 HIV 检测咨询的音频记录：在咨询前实施候诊室干预之前和之后。使用序列图分析这些咨询，以可视化和比较以下四项活动的顺序和分布：咨询、信息传递、数据收集和样本采集。
结果
在干预之前，咨询师和客户通常将重点放在客户过去风险的信息收集上，就好像它是一项调查一样。在干预后记录的咨询中，过去风险的问题分散在整个咨询中，并嵌入到对客户特定生活环境的详细讨论中。
结论
借助序列图的直接观察，可以清楚地了解咨询师和客户如何共同定位各种任务。
实践意义
我们证明了结构干预的可行性，该干预既提高了咨询质量，又提高了客户风险数据的准确性，而无需额外的咨询时间或咨询师培训。
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