初级保健中患者与医生间的电子邮件咨询：内容分析。
Email Consultations Between Patients and Doctors in Primary Care: Content Analysis.
机构信息
Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
出版信息
J Med Internet Res. 2020 Nov 9;22(11):e18218. doi: 10.2196/18218.
BACKGROUND
Increasingly, consultations in health care settings are conducted remotely using a range of communication technologies. Email allows for 2-way text-based communication, occurring asynchronously. Studies have explored the content and nature of email consultations to understand the use, structure, and function of email consultations. Most previous content analyses of email consultations in primary care settings have been conducted in North America, and these have shown that concerns and assumptions about how email consultations work have not been realized. There has not been a UK-based content analysis of email consultations.
OBJECTIVE
This study aims to explore and delineate the content of consultations conducted via email in English general practice by conducting a content analysis of email consultations between general practitioners (GPs) and patients.
METHODS
We conducted a content analysis of anonymized email consultations between GPs and patients in 2 general practices in the United Kingdom. We examined the descriptive elements of the correspondence to ascertain when the emails were sent, the number of emails in an email consultation, and the nature of the content. We used a normative approach to analyze the content of the email consultations to explore the use and function of email consultation.
RESULTS
We obtained 100 email consultations from 85 patients, which totaled 262 individual emails. Most email users were older than 40 years, and over half of the users were male. The email consultations were mostly short and completed in a few days. Emails were mostly sent and received during the day. The emails were mostly clinical in content rather than administrative and covered a wide range of clinical presentations. There were 3 key themes to the use and function of the email consultations: the role of the GP and email consultation, the transactional nature of an email consultation, and the operationalization of an email consultation.
CONCLUSIONS
Most cases where emails are used to have a consultation with a patient in general practice have a shorter consultation, are clinical in nature, and are resolved quickly. GPs approach email consultations using key elements similar to that of the face-to-face consultation; however, using email consultations has the potential to alter the role of the GP, leading them to engage in more administrative tasks than usual. Email consultations were not a replacement for face-to-face consultations.
背景
越来越多的医疗保健咨询采用各种通讯技术进行远程交流。电子邮件支持双向基于文本的异步通信。已有研究探索了电子邮件咨询的内容和性质，以了解电子邮件咨询的使用、结构和功能。之前在初级保健环境中进行的大多数电子邮件咨询内容分析都来自北美，这些研究表明，关于电子邮件咨询如何运作的担忧和假设并未实现。英国尚未进行过基于电子邮件咨询的内容分析。
目的
本研究旨在通过对英国全科医生与患者之间的电子邮件咨询进行内容分析，探讨和描绘英语全科实践中通过电子邮件进行的咨询内容。
方法
我们对英国 2 家全科医生诊所中全科医生与患者之间的匿名电子邮件咨询进行了内容分析。我们检查了通信的描述性元素，以确定电子邮件的发送时间、电子邮件咨询中的电子邮件数量以及内容的性质。我们使用规范方法分析电子邮件咨询的内容，以探索电子邮件咨询的使用和功能。
结果
我们从 85 名患者中获得了 100 封电子邮件咨询，共包含 262 封电子邮件。大多数电子邮件用户年龄在 40 岁以上，超过一半的用户为男性。电子邮件咨询通常较短，在几天内完成。电子邮件大多在白天发送和接收。电子邮件的内容大多是临床的，而不是行政的，涵盖了广泛的临床表现。电子邮件咨询的使用和功能有 3 个关键主题：全科医生和电子邮件咨询的角色、电子邮件咨询的事务性性质以及电子邮件咨询的实施。
结论
在大多数情况下，使用电子邮件与患者进行全科咨询的咨询时间较短，性质为临床性质，且解决迅速。全科医生在进行电子邮件咨询时使用与面对面咨询相似的关键要素；但是，使用电子邮件咨询有可能改变全科医生的角色，使他们比平时更多地参与行政任务。电子邮件咨询不是面对面咨询的替代品。
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