Managing the personal side of health: how patient expertise differs from the expertise of clinicians.
Managing the personal side of health: how patient expertise differs from the expertise of clinicians.
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管理健康方面：患者专业知识与临床医生的专业知识有何不同。
DOI：
10.2196/jmir.1728
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发表时间：
2011-08-16
影响因子：
7.4
通讯作者：
Pratt W
中科院分区：
文献类型：
--
作者：
Hartzler A;Pratt W
当患者需要健康信息来管理其个人健康时，他们会求助于卫生专业人员和其他患者。然而，我们对患者之间交换的信息（即患者专业知识）与卫生专业人员提供的信息（即临床医生专业知识）的对比知之甚少。了解患者的经验性专业知识如何与卫生专业人员的医疗专业知识形成对比，对于设计满足患者需求的同行支持工具是必要的，特别是随着越来越多的人通过基于互联网的社交软件分享无指导的建议。我们研究的目的是提高我们对患者专业知识的理解，并为同行支持工具的设计提供信息。我们比较了乳腺癌患者的专业知识与临床医生的专业知识的特点。通过对互联网留言板和书籍中讨论的主题和建议进行比较内容分析，我们将患者专业知识来源与临床医生专业知识来源中共享的专业知识的主题、形式和风格进行了对比。患者的专业知识集中在应对日常个人健康问题的策略上，这些问题是通过对生活经验的试错获得的;因此，它主要是个人的主题。它提供了大量可操作的建议，这些建议经常通过个人故事的叙事风格来表达，这些故事涉及在疾病期间管理与家庭、朋友、工作和家庭相关的责任和活动。相比之下，临床医生的专业知识是通过规范的风格进行的，并侧重于明确的事实和意见，与医疗保健提供系统，生物医学研究和卫生专业人员的工作密切相关。患者专家意见来源和临床专家意见来源在主题（P < .001）、形式（P < .001）和风格（P < .001）方面存在显著差异。患者为其他患者提供的专业知识与卫生专业人员提供的专业知识有很大不同。我们的研究结果表明，有经验的患者不一定是“业余医生”，他们提供的医疗信息更容易获得，但不太全面或详细。相反，它们提供了临床医生不一定能提供的有价值的个人信息。患者的专业知识和由此产生的设计影响，我们确定的特点将帮助信息学家提高同行支持工具，这将有助于满足患者的不同信息需求的设计。
When patients need health information to manage their personal health, they turn to both health professionals and other patients. Yet, we know little about how the information exchanged among patients (ie, patient expertise) contrasts with the information offered by health professionals (ie, clinician expertise). Understanding how patients’ experiential expertise contrasts with the medical expertise of health professionals is necessary to inform the design of peer-support tools that meet patients’ needs, particularly with the growing prevalence of largely unguided advice sharing through Internet-based social software. The objective of our study was to enhance our understanding of patient expertise and to inform the design of peer-support tools. We compared the characteristics of patient expertise with that of clinician expertise for breast cancer. Through a comparative content analysis of topics discussed and recommendations offered in Internet message boards and books, we contrasted the topic, form, and style of expertise shared in sources of patient expertise with sources of clinician expertise. Patient expertise focused on strategies for coping with day-to-day personal health issues gained through trial and error of the lived experience; thus, it was predominately personal in topic. It offered a wealth of actionable advice that was frequently expressed through the narrative style of personal stories about managing responsibilities and activities associated with family, friends, work, and the home during illness. In contrast, clinician expertise was carried through a prescriptive style and focused on explicit facts and opinions that tied closely to the health care delivery system, biomedical research, and health professionals’ work. These differences were significant between sources of patient expertise and sources of clinician expertise in topic (P < .001), form (P < .001), and style (P < .001). Patients offer other patients substantial expertise that differs significantly from the expertise offered by health professionals. Our findings suggest that experienced patients do not necessarily serve as “amateur doctors” who offer more accessible but less comprehensive or detailed medical information. Rather, they offer valuable personal information that clinicians cannot necessarily provide. The characteristics of patient expertise and the resulting design implications that we identified will help informaticians enhance the design of peer-support tools that will help meet patients’ diverse information needs.
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影响因子：
4.1
作者：
Frost, J;Massagli, M
通讯作者：
Massagli, M
影响因子：
2.2
作者：
Ahmed, Osman Hassan;Sullivan, S. John;McCrory, Paul
通讯作者：
McCrory, Paul
DOI：
10.1016/s1078-1439(02)00209-0
发表时间：
2003-03-01
影响因子：
2.7
作者：
Berry, DL;Ellis, WJ;Yang, C
通讯作者：
Yang, C
DOI：
10.1145/1753326.1753577
发表时间：
2010-04
期刊：
Proceedings of the SIGCHI conference on human factors in computing systems. CHI Conference
影响因子：
--
作者：
Civan-Hartzler A;McDonald DW;Powell C;Skeels MM;Mukai M;Pratt W
通讯作者：
Pratt W
影响因子：
7.4
作者：
Frost JH;Massagli MP
通讯作者：
Massagli MP