Department of Public Health, Research Unit for General Practice University of Copenhagen, Copenhagen, Denmark.
SDU Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Scand J Prim Health Care. 2024 Dec;42(4):650-658. doi: 10.1080/02813432.2024.2376744. Epub 2024 Jul 16.
To explore possible challenges to General Practitioners' (GPs') interpersonal contact with patients in video consultations (VCs), and learn how they change their communication strategies to carry out medical work in a setting with altered sensory conditions.
DESIGN, SETTING, SUBJECTS: The study included 6 GPs from the Copenhagen area, with different levels of experience of VC. The data consist of 6 interviews with GPs, held in 2021-2022. The semi-structured interviews included playback of a recorded VC between each GP and a patient, inspired by the Video-Stimulated Interview technique. Interviews were transcribed and analyzed using Interpretative Phenomenological Analysis (IPA).
GPs experienced alterations in the sensation of their patients in VCs, and worried about missing something important, including assessing the patient. Generally, GPs felt that interpersonal contact was good enough for the purpose. GPs compensated for altered sensory conditions on video by asking more questions, repeating their advice, and meta-communicating. They used their senses of sight and hearing relatively more in VCs. Compensation also took the form of triage, so that consultations on sensitive topics or with new patients were not selected to take place on video.
By compensating for altered sensory conditions in VCs, GPs can carry out their medical work sufficiently well and sustain the best possible interpersonal contact. Our findings are useful for establishing ways to maintain good interpersonal contact between GPs and patients in VCs.
探索全科医生(GP)在视频咨询(VC)中与患者进行人际接触可能面临的挑战,并了解他们如何改变沟通策略,在感官条件改变的环境中开展医疗工作。
设计、环境、对象:本研究纳入了来自哥本哈根地区的 6 名具有不同 VC 经验水平的 GP。数据包括对 6 名 GP 的访谈,访谈于 2021-2022 年进行。半结构化访谈包括播放每位 GP 与患者之间的一段记录 VC,这是受视频激发访谈技术的启发。使用解释现象学分析(IPA)对访谈进行转录和分析。
GP 们在 VC 中体验到患者感知的改变,并担心会错过一些重要的东西,包括评估患者。通常,GP 们认为人际接触足以达到目的。GP 通过询问更多问题、重复他们的建议和元沟通来补偿视频中的感官条件改变。他们在 VC 中相对更多地使用视觉和听觉感官。补偿还采取分诊的形式,因此不选择对敏感话题或新患者进行视频咨询。
通过补偿 VC 中的感官条件改变,GP 可以很好地开展他们的医疗工作,并维持尽可能好的人际接触。我们的发现对于建立在 VC 中保持 GP 和患者之间良好人际接触的方法很有用。