Padfield Deborah, Zakrzewska Joanna M, Williams Amanda C de C
Pain Res Manag. 2015 May-Jun;20(3):123-8. doi: 10.1155/2015/145964.
Visual images may facilitate the communication of pain during consultations.
To assess whether photographic images of pain enrich the content and⁄or process of pain consultation by comparing patients' and clinicians' ratings of the consultation experience.
Photographic images of pain previously co-created by patients with a photographer were provided to new patients attending pain clinic consultations. Seventeen patients selected and used images that best expressed their pain and were compared with 21 patients who were not shown images. Ten clinicians conducted assessments in each condition. After consultation, patients and clinicians completed ratings of aspects of communication and, when images were used, how they influenced the consultation.
The majority of both patients and clinicians reported that images enhanced the consultation. Ratings of communication were generally high, with no differences between those with and without images (with the exception of confidence in treatment plan, which was rated more highly in the image group). However, patients' and clinicians' ratings of communication were inversely related only in consultations with images. Methodological shortcomings may underlie the present findings of no difference. It is also possible that using images raised patients' and clinicians' expectations and encouraged emotional disclosure, in response to which clinicians were dissatisfied with their performance.
Using images in clinical encounters did not have a negative impact on the consultation, nor did it improve communication or satisfaction. These findings will inform future analysis of behaviour in the video-recorded consultations.
视觉图像可能有助于在会诊期间传达疼痛情况。
通过比较患者和临床医生对会诊体验的评分，评估疼痛的摄影图像是否丰富了疼痛会诊的内容和/或过程。
将患者之前与摄影师共同创作的疼痛摄影图像提供给参加疼痛门诊会诊的新患者。17名患者选择并使用了最能表达其疼痛的图像，并与21名未观看图像的患者进行比较。10名临床医生对每种情况进行评估。会诊后，患者和临床医生完成对沟通方面的评分，以及当使用图像时，图像对会诊的影响。
大多数患者和临床医生都报告说图像增强了会诊效果。沟通评分总体较高，观看图像和未观看图像的患者之间没有差异（治疗计划的信心除外，图像组的评分更高）。然而，仅在有图像的会诊中，患者和临床医生的沟通评分呈负相关。方法学上的缺陷可能是目前无差异结果的原因。也有可能使用图像提高了患者和临床医生的期望，并鼓励了情感披露，对此临床医生对自己的表现不满意。
在临床诊疗中使用图像对会诊没有负面影响，也没有改善沟通或满意度。这些发现将为未来对视频记录会诊中的行为分析提供参考。
