@文章{信息:doi/10.2196/17791，作者=“Stommel, Wyke J P and van Goor, Harry and Stommel, Martijn W J”，标题=“视频介导的沟通对术后闭合性伤口评估的影响:对话分析研究”，期刊=“J医学互联网研究”，年=“2020”，月=“5”，日=“5”，卷=“22”，数=“5”，页数=“e17791”，关键词=“视频会诊;远程会诊;体格检查;评估;医患关系;背景:利用视频技术进行医疗咨询的研究正在迅速增加。这一领域的大多数研究都是基于问卷调查，并关注长期状况。少数专注于视频会诊中的身体检查的研究表明，这对参与者提出了挑战。手术后咨询中通过视频评估伤口的具体活动尚未被研究。此外，对面对面和视频设置在这种活动的即时组织的比较分析是原创的。 Objective: The aim of this study was to examine the impact of video technology on the procedure of postsurgery wound assessment and its limits. Methods: We recorded 22 postoperative video consultations and 17 postoperative face-to-face consultations. The primary purpose of the consultation was to inform the patient about the final pathology results of the resected specimen, and the secondary purpose was to check on the patient's recovery, including an assessment of the closed wound. The recordings were transcribed in detail and analyzed using methods of conversation analysis. Results: The way that an assessment of the wound is established in video consultations differs from the procedure in face-to-face consultations. In the consultation room, wound assessments overwhelmingly (n=15/17) involve wound showings in the context of surgeons reporting their observations formatted with evidentials (``looks neat'') and subsequently assessing what these observations imply or what could be concluded from them. In contrast, wound assessments in video consultations do not tend to involve showing the wound (n=3/22) and, given the technological restrictions, do not involve palpation. Rather, the surgeon invites the patient to assess the wound, which opens up a sequence of patient and physician assessments where diagnostic criteria such as redness or swollenness are made explicit. In contrast to observations in regular consultations, these assessments are characterized by epistemic markers of uncertainty (``I think,'' ``sounds...good'') and evidentials are absent. Even in cases of a potential wound problem, the surgeon may rely on questioning the patient rather than requesting a showing. Conclusions: The impact of video technology on postoperative consultations is that a conclusive wound assessment is arrived at in a different way when compared to face-to-face consultations. In video consultations, physicians enquire and patients provide their own observations, which serve as the basis for the assessment. This means that, in video consultations, patients have a fundamentally different role. These talking-based assessments are effective unless, in cases of a potential problem, patient answers seem insufficient and a showing might be beneficial. ", issn="1438-8871", doi="10.2196/17791", url="//www.mybigtv.com/2020/5/e17791", url="https://doi.org/10.2196/17791", url="http://www.ncbi.nlm.nih.gov/pubmed/32310816" }