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儿科慢性病医疗问诊的音频-视频记录:观察反应性及其相关因素。

Audio-video recording of health care encounters for pediatric chronic conditions: observational reactivity and its correlates.

作者信息

Antal Holly, Hossain M Jobayer, Hassink Sandra, Henry Shannon, Fuzzell Lindsay, Taylor Alex, Wysocki Tim

机构信息

Nemours, A Children's Health System, Jacksonville, Florida, Nemours, A Children's Health System, Wilmington, Delaware, and Nemours, A Children's Health System, Orlando, Florida

Nemours, A Children's Health System, Jacksonville, Florida, Nemours, A Children's Health System, Wilmington, Delaware, and Nemours, A Children's Health System, Orlando, Florida.

出版信息

J Pediatr Psychol. 2015 Jan-Feb;40(1):144-53. doi: 10.1093/jpepsy/jsu046. Epub 2014 Jun 28.

Abstract

OBJECTIVES

Audio-video recording of pediatric clinic visits could generate observational reactivity, affecting measures of communication among patients, parents, and clinicians.

METHODS

We measured observational reactivity in a direct observation study of communication during 155 pediatric visits for any of 5 chronic conditions by coding camcorder awareness behaviors and self-report questionnaires. We analyzed associations between observational reactivity and measures of communication behavior and visit quality.

RESULTS

Directly observed camcorder awareness behaviors (634 events) comprised 0.59% of all coded events (n = 107,668). Younger children displayed these behaviors more often than did older children (F = 6.47; p < .0001). Clinicians' camcorder awareness declined significantly over successive study visits (t = -2.096; p = .043). Associations of camcorder awareness with objectively scored communication behaviors or self-reported visit quality were negligible.

CONCLUSIONS

Most recordings included slight evidence of participant camcorder awareness. But there was negligible evidence that camcorder awareness influenced clinic visit communication.

摘要

目的

儿科门诊就诊的音频视频记录可能会产生观察反应性,影响患者、家长和临床医生之间的沟通测量。

方法

我们通过对摄像机意识行为和自我报告问卷进行编码,在一项针对5种慢性疾病中任何一种的155次儿科就诊期间的沟通直接观察研究中测量观察反应性。我们分析了观察反应性与沟通行为测量和就诊质量之间的关联。

结果

直接观察到的摄像机意识行为(634个事件)占所有编码事件(n = 107,668)的0.59%。年幼儿童比年长儿童更频繁地表现出这些行为(F = 6.47;p <.0001)。在连续的研究就诊中,临床医生的摄像机意识显著下降(t = -2.096;p =.043)。摄像机意识与客观评分的沟通行为或自我报告的就诊质量之间的关联可忽略不计。

结论

大多数记录包含参与者摄像机意识的轻微证据。但几乎没有证据表明摄像机意识会影响门诊就诊沟通。

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