A Agha,Zia %A Roter,Debra L %A Schapira,Ralph M %+ HSRD圣地亚哥退伍军人事务医疗中心，拉霍亚村大道3350号(111N-1)， CA 92161，美国圣地亚哥，+1 858 552 8585 ext 7674，zia.agha@va.gov %K远程医疗%K远程会诊%K医患关系%D 2009 %7 30.9.2009 %9原始论文%J J医学互联网Res %G英语%X背景:医患沟通的质量是影响治疗结果和患者对护理的满意度的关键因素。迄今为止，很少有研究记录远程医疗(TM)对医患沟通的影响。目的:本研究的目的是测量和描述临床TM会诊期间的口头和非口头沟通，并就医患沟通质量与面对面(IP)会诊进行比较。方法:将需要肺部内科会诊的老年患者19例纳入研究。研究小组包括11名来自铁山退伍军人事务医院(VAMC)偏远地区的患者。患者在密尔沃基VAMC中心与肺部医生进行了单独的TM会诊。对照组8例患者在密尔沃基VAMC与肺部医生进行了IP会诊。使用Roter交互分析系统(RIAS)将医疗咨询的视频记录编码为患者-医生的口头和非口头交流模式。结果:TM会诊时间(22.2分钟)和IP会诊时间(21.9分钟)没有差异。 Analysis of visit dialogue indicated that the ratio of physician to patient talk was 1.45 for TM and 1.13 for IP consultations, indicating physician verbal dominance. Physicians were more likely to use orientation statements during IP consultations (P = .047). There were greater requests for repetition from patients during TM consultations (P = .034), indicating perceptual difficulties. Conclusions: The study findings indicate differences between TM and IP consultations in terms of physician-patient communication style. Results suggest that, when comparing TM and IP consultations in terms of physician-patient communication, TM visits are more physician centered, with the physician controlling the dialogue and the patient taking a relatively passive role. Further research is needed to determine whether these differences are significant and whether they have relevance in terms of health outcomes and patient satisfaction with care. %M 19793720 %R 10.2196/jmir.1193 %U //www.mybigtv.com/2009/3/e36/ %U https://doi.org/10.2196/jmir.1193 %U http://www.ncbi.nlm.nih.gov/pubmed/19793720

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