NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
Patient Educ Couns. 2013 Sep;92(3):418-25. doi: 10.1016/j.pec.2013.06.008. Epub 2013 Jul 3.
To examine informational and emotional patient-provider and patient-patient communication sequences (i.e. cues and subsequent responses) during Shared Medical Appointments (SMAs) for children and adolescents with type 1 Diabetes Mellitus (T1DM) and their parents.
57 children/adolescents with T1DM and 36 healthcare providers participated in ten SMAs in seven Dutch hospitals. Parents were present in six SMAs. Video-recordings were made. Communication sequences, including informational and emotional cues and responses were rated using an adaptation of the Medical Interview Aural Rating Scale.
143 patient-initiated cues were identified, followed by 140 provider responses and 30 patient responses. Patients gave more informational than emotional cues. Informational cues were mostly medical-related. Subsequent responses provided by providers and patients contained mostly appropriate information. We identified 17 patient and four parent cues with multiple responses.
Almost all cues were identified by healthcare providers and responded to in an appropriate manner. Cues not followed by a provider's response were picked up by other patients. Providers acted as mediator between a patient cue and another patient's response, thereby stimulating the interaction during SMAs.
Professionals could more explicitly invite all participants to interact with each other, and enable them to have their share in the communication process.
探讨儿童 1 型糖尿病患者及其父母在共同就诊时医患间和患患间的信息交流和情感交流序列（即线索及后续反应）。
在荷兰 7 家医院的 10 次共同就诊中，共有 57 名 1 型糖尿病患儿/青少年及其 36 名医护人员参与。其中 6 次就诊时父母在场。采用医疗访谈听觉评定量表的改编版对医患间的信息交流和情感交流序列，包括线索及后续反应进行评分。
共识别出 143 次患者发起的线索，随后是 140 次提供者反应和 30 次患者反应。患者提供的信息线索多于情感线索。信息线索主要与医疗相关。提供者和患者提供的后续反应主要包含适当的信息。我们识别出 17 个患者和 4 个家长线索，它们都有多次回应。
几乎所有的线索都被医护人员识别并以适当的方式做出回应。未得到提供者回应的线索被其他患者接收到。提供者在患者线索和其他患者的反应之间充当调解人，从而在共同就诊中促进了互动。
专业人员可以更明确地邀请所有参与者相互交流，并使他们在交流过程中各抒己见。
