Herzmark G
Br Med J (Clin Res Ed). 1985 Aug 3;291(6491):315-7. doi: 10.1136/bmj.291.6491.315.
The potential value of video recording for examining medical consultations depends on the extent to which recordings are representative of unfilmed consultations. This paper examines the views of 295 patients in two general practices whose consultations were filmed and compares them with the views of a control group of 185 patients. Most of those who were filmed reported that the consultation was not directly affected, and no overall effect of filming was discovered when patients rated their stress after the consultations, their rapport with the doctor, or other aspects of the consultation. At one practice, however, filming was significantly associated with lower ratings of rapport between doctor and patient among those patients who reported some direct effect of filming. Patient refusal rates from other studies are also examined and shown to vary systematically--the more opportunity patients are given to decline the more likely they are to take it. Consideration of doctors' responses to being filmed would usefully complement the emphasis on the views of patients.
视频记录在检查医疗会诊方面的潜在价值取决于录制内容能在多大程度上代表未录制的会诊情况。本文调查了两家全科诊所中295名其会诊过程被录像的患者的看法,并将他们与185名作为对照组的患者的看法进行比较。大多数被录像的患者表示会诊并未受到直接影响,而且在患者对会诊后的压力感受、与医生的融洽程度或会诊的其他方面进行评分时,未发现录像产生的总体影响。然而,在一家诊所中,对于那些报告称录像产生了一些直接影响的患者而言,录像与医患融洽程度的较低评分显著相关。其他研究中的患者拒绝率也得到了考察,结果显示其具有系统性差异——患者被给予的拒绝机会越多,他们就越有可能接受。考虑医生对被录像的反应将有效地补充对患者看法的强调。