杂志文章@ 1438- 8871% I JMIR出版物%V 22% N卡塔尔世界杯8强波胆分析 5% P e17791% T在术后会诊中，视频介导的沟通对闭合伤口评估的影响:对话分析研究%A Stommel,Wyke J P %A van Goor,Harry %A Stommel,Martijn W J %+语言研究中心，内梅亨大学，Erasmusplein 1，奈梅亨，6500 HD，荷兰，31 243612482,w.stommel@let.ru.nl %K视频咨询%K远程咨询%K体检%K评估%K医患关系%K对话分析%D 2020 %7 5.5.2020 %9原始论文%J J医学互联网Res %G英语%X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。目的:本研究旨在探讨视频技术对术后伤口评估程序的影响及其局限性。方法:记录22例术后视频会诊和17例术后面对面会诊。会诊的主要目的是告知患者切除标本的最终病理结果，次要目的是检查患者的恢复情况，包括对闭合伤口的评估。 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. %M 32310816 %R 10.2196/17791 %U //www.mybigtv.com/2020/5/e17791 %U https://doi.org/10.2196/17791 %U http://www.ncbi.nlm.nih.gov/pubmed/32310816