TY -的盟Stommel·怀克J P AU - van Goor,哈利AU - Stommel,卡坦W J PY - 2020 DA - 2020/5/5 TI - Video-Mediated通信的影响在封闭伤口评估术后磋商:谈话分析研究乔- J地中海互联网Res SP - e17791六世- 22 - 5 KW -视频咨询KW -远程咨询KW -体检千瓦评估KW -医患关系KW -谈话分析AB -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。录音被详细转录，并使用对话分析的方法进行分析。 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. SN - 1438-8871 UR - //www.mybigtv.com/2020/5/e17791 UR - https://doi.org/10.2196/17791 UR - http://www.ncbi.nlm.nih.gov/pubmed/32310816 DO - 10.2196/17791 ID - info:doi/10.2196/17791 ER -