初级保健中的沟通挑战和缓解策略 虚拟咨询:定性研究
Ahmed Alboksmaty1, Tetiana Lunova1, Ara Darzi1
1Department of Surgery and Cancer, Institute of Global Health Innovation, Imperial College London, St Mary's Campus, Norfolk Place, London, W21PG, United Kingdom, 44 7916827620.
Journal of medical Internet research
|January 20, 2026
概括
在初级保健中,虚拟咨询给全科医生和患者带来了沟通挑战. 定制培训和灵活模型等策略可以提高虚拟护理的质量和安全性.
科学领域:
- 初级医疗保健医学 一级医疗保健医学
- 卫生沟通健康沟通
- 数字健康数字健康
背景情况:
- 在初级保健中越来越多地采用虚拟咨询,这大大改变了传统的全科医生与患者的互动.
- 这些转变带来了新的挑战,影响了患者护理的质量和安全.
研究的目的:
- 调查与面对面接触相比,虚拟咨询所面临的沟通挑战和特殊差距.
- 从GP和患者的角度来看,确定有效的缓解策略来应对这些挑战.
主要方法:
- 一项定性研究涉及4个在线焦点小组,其中包括21名英国的全科医生和患者.
- 分析采用了演-诱导的主题方法,以扩展的Shannon-Weaver沟通模型和能力,机会,动机和行为 (COMB) 模型为指导.
- 报告遵守了质量研究报告综合标准 (COREQ) 的指导方针.
主要成果:
- 六个关键的沟通主题出现了:五个与香农-韦弗模型 (发送者-编码器,消息,通道,接收者-解码器-反,上下文) 和一个新的主题 (患者自主性和包容性).
- 总医生注意到缺少的视觉线索影响了信息清晰度; 患者报告了描述症状的困难,情感联系和同情心的减少.
- 缓解策略的重点是提高能力 (培训),机会 (选/工具) 和动机 (患者参与/系统适应性).
结论:
- 虚拟咨询存在明显的沟通缺口,需要有针对性的解决方案.
- 可行的策略,包括定制培训,标准化方法和灵活的模型,对于有效和包容性的虚拟沟通至关重要.
- 政策和结构化的培训对于确保安全有效的远程初级保健至关重要.
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