故事与讲述者：与简短的视频记录患者故事促进阿片类药物逐渐减量的有效性相关的因素。
The story vs the storyteller: Factors associated with the effectiveness of brief video-recorded patient stories for promoting opioid tapering.
机构信息
Department of Internal Medicine and Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA, USA.
Department of Communication, University of California, Davis, Davis, CA, USA.
出版信息
Health Expect. 2021 Jun;24(3):991-999. doi: 10.1111/hex.13243. Epub 2021 Apr 9.
BACKGROUND
Narrative communication is often more persuasive for promoting health behaviour change than communication using facts and figures; the extent to which narrative persuasiveness is due to patients' identification with the storyteller vs engagement with the story is unclear.
OBJECTIVE
To examine the relative impacts of patient engagement, age concordance and gender concordance on perceived persuasiveness of video-recorded narrative clips about opioid tapering.
METHODS
Patient raters watched and rated 48 brief video-recorded clips featuring 1 of 7 different storytellers describing their experiences with opioid tapering. The dependent variable was clips' perceived persuasiveness for encouraging patients to consider opioid tapering. Independent variables were rater engagement with the clip, rater-storyteller gender concordance and rater-storyteller age concordance (<60 vs ≥60). Covariates were rater beliefs about opioids and opioid tapering, clip duration and clip theme. Mixed-effects models accounted for raters viewing multiple clips and clips nested within storytellers.
RESULTS
In multivariable models, higher rater engagement with the clip was associated with higher perceived persuasiveness (coefficient = 0.46, 95% CI 0.39-0.53, P < .001). Neither age concordance nor gender concordance significantly predicted perceived persuasiveness. The theme Problems with opioids also predicted perceived persuasiveness.
CONCLUSION
Highly engaging, clinically relevant stories are likely persuasive to patients regardless of the match between patient and storyteller age and gender. When using patient stories in tools to promote health behaviour change, stories that are clinically relevant and engaging are likely to be persuasive regardless of storytellers' demographics.
PATIENT OR PUBLIC CONTRIBUTION
Patients were involved as storytellers (in each clip) and assessed the key study variables.
背景
与使用事实和数据进行沟通相比，叙事沟通通常更能促进健康行为的改变；但不清楚叙事说服力在多大程度上归因于患者对讲述者的认同，以及他们对故事的投入。
目的
研究患者投入度、年龄一致性和性别一致性对观看关于阿片类药物逐渐减量的视频记录叙事片段后，对其感知说服力的相对影响。
方法
患者评估者观看并对 48 个简短的视频记录片段进行评分，这些片段由 7 位不同讲述者中的 1 位描述他们的阿片类药物逐渐减量经历。因变量为鼓励患者考虑阿片类药物逐渐减量的视频记录片段的感知说服力。自变量为评估者对视频记录片段的投入度、评估者与讲述者的性别一致性以及评估者与讲述者的年龄一致性（<60 岁与≥60 岁）。协变量为评估者对阿片类药物和阿片类药物逐渐减量的看法、片段时长和片段主题。混合效应模型考虑了评估者观看多个片段以及嵌套在讲述者内的片段。
结果
在多变量模型中，评估者对视频记录片段的投入度越高，感知说服力越高（系数=0.46，95%CI 0.39-0.53，P<0.001）。年龄一致性和性别一致性都不能显著预测感知说服力。主题“阿片类药物存在问题”也预测了感知说服力。
结论
无论患者与讲述者的年龄和性别是否匹配，高度投入、具有临床相关性的故事都可能对患者具有说服力。在使用患者故事来促进健康行为改变的工具中，无论讲述者的人口统计学特征如何，具有临床相关性和吸引力的故事都可能具有说服力。
患者或公众的贡献
患者作为讲述者（在每个片段中）参与，并评估了关键的研究变量。
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