Cruickshank P J
Soc Sci Med. 1985;21(6):615-22. doi: 10.1016/0277-9536(85)90200-x.
In order to shed some light on the impact of a computer on medical consultations, 140 new hospital out-patients rated the doctor they had just seen, and their ideal doctor using a 38-item semantic differential-type scale. Sixty-four of the patients had experienced a computer being used by one of the three doctors participating in the study. Each patient's ratings of a doctor were compared with their ratings of the ideal doctor by paired t-tests. The doctors, when using the computer, tended to be seen as less matching up to these ideals than when they did not use the computer. All three received more non-ideal ratings when using the computer. However, this was less so for two of the doctors than for the third, who with a computer was seen as less than ideally listening and paying attention, and was also rated as less than ideally warm, friendly, liking and comforting, perhaps surprisingly, this doctor had tried to minimize the effect of the computer during the consultation, while the doctor who used the computer 'conversationally' during the interview was rated overall as better with it than without it. It would appear that the pattern of computer use in the consultation and even its apparent intrusiveness need not have an adverse effect on patient ratings of doctors, but that computer use can cause problems for this aspect of the doctor-patient relationship.
为了深入了解计算机对医疗咨询的影响,140名新的门诊患者使用一个包含38个项目的语义差异型量表对他们刚看过的医生以及他们理想中的医生进行了评价。其中64名患者体验过参与研究的三名医生之一使用计算机的情况。通过配对t检验将每位患者对医生的评分与其对理想医生的评分进行比较。结果发现,与不使用计算机时相比,医生在使用计算机时往往被认为与这些理想标准的契合度较低。三名医生在使用计算机时都收到了更多不理想的评分。然而,其中两名医生的情况比第三名医生要轻一些,第三名医生在使用计算机时被认为倾听和关注程度不够理想,在热情、友好、亲切和安慰方面也得到了不理想的评分。也许令人惊讶的是,这位医生在咨询过程中试图尽量减少计算机的影响,而在问诊过程中“自然地”使用计算机的医生总体上被认为使用计算机时比不使用时表现更好。看来,咨询中计算机的使用模式甚至其明显的干扰性不一定会对患者对医生的评分产生不利影响,但计算机的使用可能会在医患关系的这一方面引发问题。