A digital advocate? Reactions of rural people who experience homelessness to the idea of recording clinical encounters.
A digital advocate? Reactions of rural people who experience homelessness to the idea of recording clinical encounters.
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DOI：
10.1111/hex.12492
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发表时间：
2017-08
期刊：
影响因子：
--
通讯作者：
Elwyn G
中科院分区：
文献类型：
--
作者：
Grande SW;Castaldo MG;Carpenter-Song E;Griesemer I;Elwyn G
记录临床接触的好处是在不同的群体之间分享的，还是根据社会地位的不同而不同？研究表明，受过教育的患者会记录他们的临床就诊情况，以增强他们的体验，但人们对记录“难以接触到的”人群的益处知之甚少。为了调查无家可归者对使用智能手机记录他们自己的临床遭遇的想法的反应，无论是秘密地还是在他们的医生允许的情况下。我们在新英格兰北部的一个临时住房收容所对个人进行了半结构化的采访。专题分析确定了反复细化为具有代表性的群体的主题。共进行了18次访谈，其中12次为女性，6次为男性。对临床记录的初步反应为阳性(18例中有11例)。大多数人(18人中有17人)愿意在未来的访问中使用录音。一项专题分析以两种方式描述了数据的特点：(I)通过为审查提供可靠的证据，这些数据充当了对患者的宣传措施；(Ii)通过提高透明度和拉近社会距离，这项技术改善了临床关系。录音允许与其他人共享数据，提供了行为的具体证据，并驳斥了错误的概念。请求记录的许可似乎改变了与临床医生的关系，并拉近了人们对社交距离的感知。我们发现，虽然许多农村、弱势群体因与临床医生之间的巨大社会距离而感到被边缘化，但记录技术可以作为一种倡导者，让患者和医生都承担责任，并允许分担临床证据的负担。
Are the benefits of recording clinical encounters shared across different groups, or do they vary based on social position? Studies show that educated patients record their clinical visits to enhance their experience, but very little is known about recording benefits among “hard‐to‐reach” populations. To examine the reactions of homeless people to the idea of using a smartphone to record their own clinical encounter, either covertly or with permission from their physician. We conducted semi‐structured interviews with individuals at a temporary housing shelter in Northern New England. A thematic analysis identified themes that were iteratively refined into representative groups. Eighteen (18) interviews were conducted, 12 with women and six with men. Initial reactions to clinical recordings were positive (11 of 18). A majority (17 of 18) were willing to use recordings in future visits. A thematic analysis characterized data in two ways: (i) by providing reliable evidence for review, they functioned as an advocacy measure for patients; (ii) by promoting transparency and levelling social distance, this technology modified clinical relationships. Recordings permitted the sharing of data with others, providing tangible proof of behaviour and refuting misconceptions. Asking permission to record appeared to modify relationships and level perceived social distance with clinicians. We found that while many rural, disadvantaged individuals felt marginalized by the wide social distance between themselves and their clinicians, recording technology may serve as an advocate by holding both patients and doctors accountable and by permitting the burden of clinical proof to be shared.
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影响因子：
6.1
作者：
Akerlof, GA
通讯作者：
Akerlof, GA
影响因子：
1
作者：
Schei, Edvin
通讯作者：
Schei, Edvin
影响因子：
2.7
作者：
Schnittker, J
通讯作者：
Schnittker, J
影响因子：
3.5
作者：
Tiedje K;Shippee ND;Johnson AM;Flynn PM;Finnie DM;Liesinger JT;May CR;Olson ME;Ridgeway JL;Shah ND;Yawn BP;Montori VM
通讯作者：
Montori VM
影响因子：
6
作者：
DiCicco-Bloom, B;Crabtree, BF
通讯作者：
Crabtree, BF