Department of Advertising, College of Journalism and Communications, University of Florida, United States.
Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System,United States.
Patient Educ Couns. 2017 Oct;100(10):1852-1858. doi: 10.1016/j.pec.2017.04.019. Epub 2017 May 2.
Patients are increasingly using the secure messaging function available through online patient portals to communicate with their health care providers, yet little is known about the characteristics of conversations that occur. The goal of this study is to describe the types of messages initiated by patients communicating via patient portals and to assess whether providers employ patient-centered strategies in their electronic responses.
A total of 193 messages from 58 message threads between patients and providers were collected during a one-week period in a large health care system.
Content analysis of patient messages was conducted and deductive analysis of provider responses was employed for two types of patient-centered communication, provider use of supportive talk and partnership building.
Patients sent nearly double the number of messages compared to providers (65% versus 35%). Patient messages expressed concern, sought medical solutions and requested assistance with administrative tasks. Over half (53.4%) of provider replies did not contain language reflective of either partnership building or supportive talk.
Partnership building language and supportive talk occurred at lower rates than documented in the literature on in-person encounters. This may represent a lost opportunity to strengthen the patient-provider relationship.
As secure messaging is increasingly utilized as a form of patient-provider communication, it is important to understand how aspects of this communication channel, including the patient-centeredness of the language used by providers, impact patient-provider relationships and patient outcomes.
患者越来越多地使用在线患者门户提供的安全消息传递功能与他们的医疗保健提供者进行沟通，但对于发生的对话特征知之甚少。本研究的目的是描述通过患者门户进行沟通的患者发起的消息类型，并评估提供者在其电子回复中是否采用了以患者为中心的策略。
在一个大型医疗保健系统中，在一周的时间内收集了来自 58 个患者和提供者之间的消息线程的 193 条消息。
对患者消息进行内容分析，并对提供者回复采用两种以患者为中心的沟通方式进行演绎分析，即提供者使用支持性谈话和建立伙伴关系。
与提供者相比，患者发送的消息数量几乎是其两倍（65%对 35%）。患者的信息表达了关切、寻求医疗解决方案并请求协助处理行政任务。超过一半（53.4%）的提供者回复中没有包含建立伙伴关系或支持性谈话的语言。
与文献中记录的面对面交流相比，伙伴关系建立语言和支持性谈话的发生率较低。这可能代表着加强医患关系的机会丧失。
随着安全消息传递越来越多地被用作医患沟通的一种形式，了解此沟通渠道的各个方面，包括提供者使用的语言是否以患者为中心，如何影响医患关系和患者结果非常重要。
