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识别临床医生与癌症患者之间安全信息中以患者为中心的沟通机制。

Identifying the mechanisms of patient-centred communication in secure messages between clinicians and cancer patients.

作者信息

Raisa Aantaki, Alpert Jordan M, Bylund Carma L, Jarad-Fodeh Samah

机构信息

College of Journalism and Communications, University of Florida, Gainesville, FL, USA.

College of Medicine, University of Florida, Gainesville, FL, USA.

出版信息

PEC Innov. 2023 May 8;2:100161. doi: 10.1016/j.pecinn.2023.100161. eCollection 2023 Dec.

Abstract

OBJECTIVE

Identify how patients and clinicians incorporate patient-centered communication (PCC) within secure messaging.

METHODS

A random sample of 199 secure messages from patient portal communication between patients and clinicians were collected and analyzed. Via manual annotation, the task of tagging target words/phrases in text, we identified five components of PCC: information giving, information seeking, emotional support, partnership, and shared decision-making. Textual analysis was also performed to understand the context of PCC expressions within messages.

RESULTS

Information-giving was the predominant ( = 346, 68.1%) PCC category used in secure messaging, more than double of the other four PCC codes, information-seeking ( = 82, 16.1%), emotional support ( = 52, 10.2%), shared decision making (n = 5, 1.0%), combined. The textual analysis revealed that clinicians informed patients about appointment reminders and new protocols while patients reminded clinicians about upcoming procedures and outcomes of test results conducted by other clinicians. Although less common, patients expressed statements of concern, uncertainty, and fear; enabling clinicians to provide support.

CONCLUSION

Secure messaging is mainly used for exchanging information, but other aspects of PCC emerge using this channel of communication.

INNOVATION

Meaningful discussions can occur via secure messaging, and clinicians should be mindful of incorporating PCC when communicating with patients through secure messaging.

摘要

目的

确定患者和临床医生如何在安全信息传递中融入以患者为中心的沟通(PCC)。

方法

收集并分析了从患者门户中患者与临床医生之间的沟通记录里随机抽取的199条安全信息。通过人工标注文本中目标单词/短语的任务,我们确定了PCC的五个组成部分:信息提供、信息寻求、情感支持、伙伴关系和共同决策。还进行了文本分析,以了解信息中PCC表达的背景。

结果

信息提供是安全信息传递中使用的主要PCC类别(=346,68.1%),是其他四个PCC代码(信息寻求(=82,16.1%)、情感支持(=52,10.2%)、共同决策(n=5,1.0%))总和的两倍多。文本分析显示,临床医生向患者告知预约提醒和新方案,而患者则提醒临床医生即将进行的程序以及其他临床医生进行的检查结果。虽然不太常见,但患者表达了担忧、不确定和恐惧的陈述,使临床医生能够提供支持。

结论

安全信息传递主要用于交换信息,但通过这种沟通渠道也出现了PCC的其他方面。

创新点

通过安全信息传递可以进行有意义的讨论,临床医生在通过安全信息传递与患者沟通时应注意融入PCC。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a481/10294087/eb175586aa18/gr1.jpg

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