Coleman T, Manku-Scott T
University of Leicester, Department of General Practice and Primary Health Care, Leicester General Hospital.
Br J Gen Pract. 1998 Feb;48(427):971-4.
Video-recorded consultations are widely used for research in general practice. Recently, video recordings have begun to be used for the purposes of general practitioner (GP) registrar assessment. It is unknown, however, whether consultations in which patients withhold consent for recording differ from those that are recorded.
To compare clinical problems and demographic characteristics of adult patients who consent to the video recording of consultations with those who withhold consent.
This was prospective study of 538 adult patients consulting 42 GPs, based in practices throughout Leicestershire. Each patient attended a surgery session with one of the 42 GPs between April 1995 and March 1996. Clinical presentations and demographic characteristics of patients consenting and withholding consent to the video recording of their consultations were compared. GPs' perceptions of whether patients in these two groups were distressed/upset or embarrassed were also compared.
A total of 85.9% (462/538) of adults consented to video recording, and 14.1% (76/538) withheld consent. Multiple logistic regression revealed that patients who presented with a mental health problem were more likely to withhold consent to recording (odds ratio 2.5, 95% confidence interval 1.4-4.6). Younger patients were also more likely to withhold consent to video recording. Additionally, where patients' consent was withheld, GPs perceived patients to be more distressed or embarrassed.
Younger patients and those suffering from mental health problems are more likely than others to withhold consent to being video recorded for research purposes in general practice. The implications of this study for the assessment of registrar GPs using video-recorded consultations are discussed.
视频录制的会诊广泛应用于全科医疗研究。最近，视频录制开始用于全科医生（GP）注册实习生的评估。然而，患者不同意录制的会诊与已录制的会诊是否存在差异尚不清楚。
比较同意视频录制会诊的成年患者与不同意录制的成年患者的临床问题和人口统计学特征。
这是一项对莱斯特郡各地诊所的42名全科医生接诊的538名成年患者进行的前瞻性研究。1995年4月至1996年3月期间，每位患者与42名全科医生中的一位进行了一次诊疗。比较了同意和不同意视频录制其会诊的患者的临床表现和人口统计学特征。还比较了全科医生对这两组患者是否感到痛苦/不安或尴尬的看法。
共有85.9%（462/538）的成年人同意视频录制，14.1%（76/538）的人不同意。多元逻辑回归显示，存在心理健康问题的患者更有可能不同意录制（优势比2.5，95%置信区间1.4 - 4.6）。年轻患者也更有可能不同意视频录制。此外，在患者不同意的情况下，全科医生认为患者更痛苦或尴尬。
在全科医疗中，年轻患者和患有心理健康问题的患者比其他人更有可能不同意为研究目的而被视频录制。讨论了本研究对使用视频录制会诊评估注册全科医生的意义。
