Van den Heuvel Johannes, Assing Hvidt Elisabeth, Dahl-Larsen Rasmus, Thomsen Janus Laust, Hoffmann Merrild Camilla
Center for General Practice, Aalborg University Department of Clinical Medicine, Aalborg, Region Nordjylland, Denmark.
Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Syddanmark, Denmark.
Digit Health. 2024 Oct 8;10:20552076241288637. doi: 10.1177/20552076241288637. eCollection 2024 Jan-Dec.
This qualitative study explores when and why patients book video consultations through an online booking platform within the context of Danish general practice and how the technology affects patients' use of this consultation type.
We conducted thirteen semi-structured interviews with patients from the same general practice who were experienced users of video consultations scheduled through the clinic's online booking platform. Interviews were analysed using thematic analysis and drawing on actor-network theory and Bruno Latour's concept of technical mediation as an analytical framework.
We introduce the concept of "hybrid patients," highlighting how values tied to video consultation that motivates patients to book them emerge through technical mediation in the network between patients, general practitioners (GPs) or practice staff, and the video technology. We identified three emerging values: efficiency, control and diminished presence. Video consultation affords efficient consultations that save patients' time. It mediates patients' sense of control when they experience certainty concerning their health issues. Video consultation mediates diminished presence that increases relational distance. However, it simultaneously allows for efficiency and emotional distance between patients and their GP, and between patients and their health issues.
When initiating the use of video consultation, the patient plays an active and conscious role in adjusting to the mediated values (efficiency, control and diminished presence) linked to this form of consultation. These emerging values are context-specific, and patients employ them based on their individual requirements. Patients trust their GPs to prevent severe or vulnerable topics from being discussed in a video consultation.
本定性研究探讨在丹麦全科医疗背景下，患者何时以及为何通过在线预约平台进行视频会诊，以及该技术如何影响患者对这种会诊类型的使用。
我们对来自同一全科诊所的患者进行了13次半结构化访谈，这些患者是通过诊所在线预约平台安排视频会诊的经验丰富的用户。访谈采用主题分析法进行分析，并借鉴行动者网络理论以及布鲁诺·拉图尔的技术调解概念作为分析框架。
我们引入了“混合患者”的概念，强调了与视频会诊相关的价值观如何通过患者、全科医生（GP）或诊所工作人员以及视频技术之间网络中的技术调解，促使患者预约视频会诊。我们确定了三个新出现的价值观：效率、控制和在场感减弱。视频会诊提供高效的会诊，节省患者时间。当患者对自己的健康问题有把握时，它能调节患者的控制感。视频会诊调解了在场感减弱，增加了关系距离。然而，它同时允许患者与他们的全科医生之间以及患者与他们的健康问题之间保持效率和情感距离。
在开始使用视频会诊时，患者在适应与这种会诊形式相关的调解价值观（效率、控制和在场感减弱）方面发挥着积极且有意识的作用。这些新出现的价值观是特定于情境的，患者根据个人需求来运用它们。患者信任他们的全科医生，以防止在视频会诊中讨论严重或敏感的话题。
