远程医疗咨询中的沟通：全科医生及其患者的观点。

Communication during telemedicine consultations in general practice: perspectives from general practitioners and their patients.

机构信息

Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia.

St Vincent's Clinical Campus, UNSW Sydney, Sydney, NSW, Australia.

出版信息

BMC Prim Care. 2024 Sep 4;25(1):324. doi: 10.1186/s12875-024-02576-1.

DOI:10.1186/s12875-024-02576-1

PMID:39232645

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11373490/

Abstract

BACKGROUND

Telemedicine allows delivery of healthcare to occur between parties that are not in the same location. As telemedicine users are not co-present, effective communication methods are crucial to the delivery and reception of information. The aim of this study was to explore perspectives of general practitioners (GPs) and patients on the interactional components of telemedicine consultations.

METHODS

Semi-structured qualitative interviews were held with telemedicine users; 15 GPs and nine patients self-selected from a larger telemedicine study. Participants were asked about their preparation for telemedicine consultations, conducting telemedicine consultations and post-consultation activities. Deidentified transcripts from the interviews were analysed thematically.

RESULTS

GPs and patients discussed factors they used to decide whether a consultation would be best conducted by telemedicine or in-person; the condition to be discussed, the existing doctor-patient relationship and whether physical examination was required. Participants also described how they prepared for their telemedicine consultations, gathering relevant documents, and reading previous notes. Participants described strategies they employed to optimise the telemedicine interaction; improving conversational flow and building rapport, as well as difficulties they experienced when trying to provide and receive care via telemedicine.

CONCLUSIONS

Patient factors including health literacy and familiarity with technology affect the transfer of information shared during telemedicine consultations and consideration of these factors when choosing patients for telemedicine is required. Many GPs and patients have innate communication skills to effectively deliver and receive care through telemedicine. However, they may not be aware of these subconscious techniques to use to optimise telemedicine consultations. Communication training could be delivered to increase conversational flow, build rapport, and establish safety netting.

摘要

背景

远程医疗允许在不在同一地点的双方之间进行医疗保健服务。由于远程医疗用户无法面对面交流，因此有效的沟通方法对于信息的传递和接收至关重要。本研究旨在探讨全科医生（GP）和患者对远程医疗咨询互动环节的看法。

方法

对来自一项更大规模远程医疗研究的 15 名全科医生和 9 名患者进行了半结构化定性访谈。参与者被问及他们对远程医疗咨询的准备、进行远程医疗咨询和咨询后的活动。对访谈的匿名转录本进行了主题分析。

结果

全科医生和患者讨论了他们用来决定咨询是否最好通过远程医疗或面对面进行的因素；要讨论的病情、现有的医患关系以及是否需要体检。参与者还描述了他们为远程医疗咨询做准备的方式，包括收集相关文件和阅读以前的记录。参与者描述了他们为优化远程医疗互动而采用的策略；改善对话流程和建立融洽关系，以及在尝试通过远程医疗提供和接收护理时遇到的困难。

结论

患者的健康素养和对技术的熟悉程度等因素会影响远程医疗咨询中共享的信息传递，因此在选择远程医疗患者时需要考虑这些因素。许多全科医生和患者具有有效的沟通技巧，可以通过远程医疗有效地提供和接收护理。然而，他们可能没有意识到这些潜意识的技巧来优化远程医疗咨询。可以提供沟通培训，以增加对话流畅度、建立融洽关系并建立安全网。