Healthcare Services Research Unit (HØKH), Akershus University Hospital, Lorenskøg, Norway.
Institute of Clinical Medicine, University of Oslo, Lorenskøg, Norway.
Qual Health Res. 2024 Jan;34(1-2):101-113. doi: 10.1177/10497323231205152. Epub 2023 Oct 23.
During medical consultations, physicians need to share a substantial amount of information with their patients. this information is framed can be crucial for patient understanding and outcomes, but little is known about the details of how physicians frame information in practice. Using an inductive microanalysis approach in the study of videotaped medical interactions, we aimed to identify the (i.e., higher-level ways of organizing and structuring information to reach a particular purpose) and the (i.e., any dialogic mechanism used to present information in a particular way that shapes how the patient might perceive and interpret it) physicians use spontaneously and intuitively while sharing information with their patients. We identified 66 different information-framing devices acting within nine information frames conveying: (1) Do we agree that we share this knowledge?, (2) I don't like where I (or where you are) am going with this, (3) This may be tricky to understand, (4) You may need to think, (5) This is important, (6) This is not important, (7) This comes from me as a doctor, (8) This comes from me as a person, and (9) This is directed to you as a unique person. The kaleidoscope of information-framing devices described in this study reveals the near impossibility for neutrality and objectivity in the information-sharing practice of medical care. It also represents an inductively derived starting point for further research into aspects of physicians' information-sharing praxis.
在医疗咨询中，医生需要与患者分享大量信息。信息的呈现方式对于患者的理解和治疗效果至关重要，但我们对于医生在实践中如何呈现信息的具体细节知之甚少。本研究采用归纳式微观分析方法，对录像医疗互动进行研究，旨在确定医生在与患者分享信息时，自发且直观使用的信息框架（即，以特定目的组织和构建信息的更高层次方式）和信息呈现方式（即，用于以特定方式呈现信息的任何对话机制，从而影响患者对信息的感知和解释）。我们确定了 66 种不同的信息框架手段，它们在九个信息框架中发挥作用，传递了以下信息：（1）我们是否同意我们分享这个知识？（2）我不喜欢我们现在的进展方向。（3）这可能很难理解。（4）你可能需要思考。（5）这很重要。（6）这并不重要。（7）这是作为医生的我提供的。（8）这是作为个人的我提供的。（9）这是针对你个人的。本研究中描述的信息框架手段的万花筒揭示了医疗保健中信息共享实践中几乎不可能保持中立和客观。它也代表了进一步研究医生信息共享实践方面的一个归纳式起点。
