Health Services Research Unit HØKH, Akershus University Hospital, Lørenskog, Norway; Department of Neurology, Akershus University Hospital, Lørenskog, Norway; University of Oslo, Norway.
Health Services Research Unit HØKH, Akershus University Hospital, Lørenskog, Norway.
Patient Educ Couns. 2022 Jun;105(6):1552-1560. doi: 10.1016/j.pec.2021.10.013. Epub 2021 Oct 13.
To define and operationalize three taught strategies for providing information in interactions with patients using videos collected in a randomized controlled trial (RCT).
This was a qualitative exploratory study embedded in a randomized controlled design, using microanalysis of face-to-face dialogue as an inductive video analysis method to operationalize physicians' use of three information-provision strategies. Data were 34 video-recorded simulated (but unscripted) interactions between 17 physicians and 34 multiple sclerosis patients collected before and after a brief course on information provision. We operationalized (1) mapping the patient's preferences and (2) checking the patient's understanding, and pauses indicative of (3) portioning information.
Results are detailed analytical definitions, criteria, and assessable, quantifiable outcomes for each of the three strategies. Patients responded to portioning pauses as expected: whereas 91% of these pauses elicited an immediate patient response, only 23% of non-portioning pauses did so.
Our methods revealed how to define and evaluate information sharing strategies physicians used within the contingencies of clinical interaction.
Findings provide applicable methods to teach, analyze, and evaluate information sharing strategies and indications for further training.
利用从随机对照试验（RCT）中收集的视频，定义和操作三种在与患者互动时提供信息的教学策略。
这是一项嵌入随机对照设计的定性探索性研究，使用面对面对话的微观分析作为一种归纳性视频分析方法，将医生使用的三种信息提供策略操作化。数据来自 17 名医生和 34 名多发性硬化症患者之间 34 次预先录制的模拟（但未脚本化）互动，这些互动是在简短的信息提供课程之前和之后收集的。我们操作化了（1）绘制患者偏好，（2）检查患者理解，以及（3）划分信息的停顿。
结果是对三种策略中的每一种策略的详细分析定义、标准和可评估、可量化的结果。患者对划分停顿的反应如预期：91%的停顿会引起患者立即回应，而非划分停顿只有 23%会引起回应。
我们的方法揭示了如何在临床互动的情况下定义和评估医生使用的信息共享策略。
研究结果提供了适用于教授、分析和评估信息共享策略以及进一步培训的方法。
