Bavngaard Martin Vinther, Lüchau Elle Christine, Hvidt Elisabeth Assing, Grønning Anette
Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Digit Health. 2023 Jun 5;9:20552076231180682. doi: 10.1177/20552076231180682. eCollection 2023 Jan-Dec.
Video consultations enable a digital point of contact between the general practitioner and patient. With their medium-specific characteristics, video consultations may create novel conditions for the enactment of patient participation during consultations. Although numerous studies have explored patients' experiences of video consultations, research explicitly investigating patient participation within this new consultation setting remains sparse. This qualitative study explores how patients participate during interactions with their general practitioner by drawing on the affordances of video consultations.
The data corpus comprises eight recorded video consultations (59 minutes and 19 seconds in total) between patients and their general practitioner, all subjected to reflexive thematic analysis yielding three themes illustrating concrete participatory use cases.
We find that video consultations provide an accessible format for patients otherwise unable to attend a physical consultation due to physical and mental barriers. Moreover, patients participate by drawing on resources situated in their spatial setting to settle health-related questions of doubt arising during the consultation. Lastly, we posit that patients enact participation by visually communicating their impromptu engagement in decision-making and reporting to their general practitioner by making use of the qualities of their smartphone during their consultation.
Our findings illustrate how video consultations provide a communicative context in which patients may enact distinct forms of participation by drawing on its technologically contingent affordances during interactions with their general practitioner. More research is needed to explore the participatory opportunities of video consultations in telemedical healthcare services for different patient groups.
视频会诊实现了全科医生与患者之间的数字化联系点。视频会诊因其特定媒介的特性，可能为会诊期间患者参与的实施创造新的条件。尽管众多研究探讨了患者的视频会诊体验，但明确调查这种新会诊环境中患者参与情况的研究仍然很少。这项定性研究通过利用视频会诊的特性，探索患者在与全科医生互动时如何参与。
数据语料库包括患者与其全科医生之间的八次视频会诊记录（总计59分19秒），所有记录都经过反思性主题分析，得出三个主题，阐明了具体的参与用例。
我们发现，视频会诊为因身体和精神障碍而无法参加面对面会诊的患者提供了一种可及的形式。此外，患者通过利用其空间环境中的资源来解决会诊期间出现的与健康相关的疑问，从而参与其中。最后，我们认为患者通过在会诊期间利用智能手机的特性，以视觉方式向全科医生传达他们在决策和报告中的即兴参与，从而实现参与。
我们的研究结果表明，视频会诊如何提供一个交流环境，在这个环境中，患者在与全科医生互动时，可以通过利用其技术上的偶然特性来实现不同形式的参与。需要更多研究来探索视频会诊在针对不同患者群体的远程医疗保健服务中的参与机会。
