Barr Paul J, Wasp Garrett T, Dannenberg Michelle D, Mistler Lisa A, Verma Kanak, Bonasia Kyra, Haslett William R, Ganoe Craig H, Bratches Reed W, Schifferdecker Karen
The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, New Hampshire, USA.
Center for Technology and Behavioral Health, Dartmouth College, Lebanon, New Hampshire, USA.
Health Expect. 2025 Feb;28(1):e70143. doi: 10.1111/hex.70143.
We aimed to understand what patients, caregivers and clinicians identified as the most important information from their audio-recorded clinic visits and why.
We recruited patients, caregivers and clinicians from primary and speciality care clinics at an academic medical centre in New Hampshire, U.S. Participants reviewed a recording or transcript of their visit, identifying meaningful moments and the reasons why. Two researchers performed a summative content analysis of the data.
Sixteen patients, four with caregivers, from six clinicians participated. Patients, caregivers and clinicians identified a median of 7.5 (3-20), 12.5 (6-50) and 18 (4-31) meaningful visit moments, respectively. Moments identified were similar across stakeholders, including patient education, symptoms, recommendations and medications. Four themes emerged as a rationale for finding visit information meaningful: providing and receiving information, sharing the patient experience, forming a care plan, and providing emotional support. Clinicians rarely identified patient statements as important.
There was considerable agreement between patients, clinicians and caregivers regarding visit information that is most valuable. Patient contributions may be undervalued by clinicians.
These findings can be used to improve patient-centred visit communication by focusing visit summaries and decision support on information of the most value to participants.
我们旨在了解患者、护理人员和临床医生从他们的门诊就诊录音中确定的最重要信息是什么以及原因。
我们从美国新罕布什尔州一家学术医疗中心的初级和专科护理诊所招募患者、护理人员和临床医生。参与者查看他们就诊的录音或文字记录，确定有意义的时刻及其原因。两名研究人员对数据进行了总结性内容分析。
来自六位临床医生的16名患者（其中4名有护理人员陪同）参与了研究。患者、护理人员和临床医生分别确定的有意义就诊时刻的中位数为7.5（3 - 20）、12.5（6 - 50）和18（4 - 31）。各利益相关者确定的时刻相似，包括患者教育、症状、建议和药物。出现了四个主题，作为认为就诊信息有意义的理由：提供和接收信息、分享患者经历、制定护理计划以及提供情感支持。临床医生很少将患者的陈述视为重要信息。
患者、临床医生和护理人员在最有价值的就诊信息方面存在相当大的共识。临床医生可能低估了患者的贡献。
这些发现可用于通过将就诊总结和决策支持聚焦于对参与者最有价值的信息来改善以患者为中心的就诊沟通。
