Revealing moments: formulating understandings of adverse experiences in a health appraisal interview
Revealing moments: formulating understandings of adverse experiences in a health appraisal interview
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DOI：
10.1016/s0277-9536(00)00118-0
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发表时间：
2001-01-01
影响因子：
5.4
通讯作者：
Dixson, CN
中科院分区：
文献类型：
--
作者：
Beach, WA;Dixson, CN
健康评估访谈的分析揭示了访谈者如何使用公式来组织谈论患者的病史。当患者选择的报告被解释时，启动三部分的公式化循环：（1）采访者的公式化理解，（2）患者的确认，和（3）采访者的话题转移。这种干预模式的重现促使人们越来越关注患者的不良经历，将其视为成年人健康状况的“根本问题”（例如骚扰、肥胖、抑郁）。创造一个环境，为病人的紧急披露是促进显示非判断敏感性，病人的陈述的关注，征求对齐特定的重建和避免过早地向前移动的采访，并在病人的疾病情况下没有接地的问题。识别和利用的沟通技术，参加病人的生物心理社会史是至关重要的，以完善理解移情访谈，提高诊断和治疗（如转诊），减少病人的医疗保健系统的使用，并最终降低成本的质量医疗服务。(C)2000爱思唯尔科技有限公司版权所有。
Analysis of a health appraisal interview reveals how an interviewer employs formulations to organize talk about a patient's medical history. When selected reportings by patient are paraphrased, a three-part formulations cycle is initiated: (1) interviewer's formulated understandings, (2) patient's confirmation, and (3) topic shift by interviewer. The reenactment of this interactional pattern promotes increasing attention to patient's adverse experiences as "root problems" underlying adult health status (e.g. molestation, obesity, depression). Creating an environment for patient's emergent disclosures is facilitated by displaying non-judgmental sensitivity to patient's stated concerns, soliciting alignment to particular reconstructions and avoidance of moving the interview forward prematurely and to issues not grounded in patient's illness circumstances. The identification and utilization of communication techniques for attending to patient's bio-psycho-social history is critical for refining understandings of empathic interviewing, enhancing diagnosis and treatment (e.g. referrals), decreasing patients' utilization of health care systems, and ultimately reducing costs for quality medical care. (C) 2000 Elsevier Science Ltd. All rights reserved.