Patient Satisfaction with Physician-Patient Communication During Telemedicine
Patient Satisfaction with Physician-Patient Communication During Telemedicine
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DOI：
10.1089/tmj.2009.0030
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发表时间：
2009-11-01
期刊：
影响因子：
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通讯作者：
Roter, Debra L.
中科院分区：
文献类型：
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作者：
Agha, Zia;Schapira, Ralph M.;Roter, Debra L.
医患沟通的质量是治疗结果和患者对护理满意度的关键因素。到目前为止，很少有研究专门进行了深入的评估远程医疗（TM）的影响，在医疗环境中的医患沟通。我们的目标是确定是否物理隔离和技术使用TM有负面影响的医患沟通。在这项非劣效性随机临床试验中，患者随机接受9名医生之一的单次咨询，无论是亲自（IP）还是通过TM。患者（n = 221）从中西部退伍军人管理局医院的肺，内分泌和风湿病诊所招募。医患沟通的测量使用一个有效的自我报告问卷，包括33个项目的访问方便和医生的以病人为中心的沟通，临床能力和人际交往能力的测量满意度。两种咨询类型的医生以患者为中心的沟通满意度相似（TM = 3.76 vs IP = 3.61），TM的非劣效性得到证实（非劣效性t检验p = 0.002）。患者对医生临床能力（TM = 4.63 vs IP = 4.52）和医生人际交往能力（TM = 4.79 vs IP = 4.74）的满意度相似，TM的非劣效性得到证实（非劣效性t检验分别为p = 0.006和p = 0.04）。与IP咨询相比，患者对TM的便利性更满意（TM = 4.41 vs IP = 2.37，非劣效性t检验p < 0.001）。患者同样满意医生的能力，以发展融洽的关系，使用共享的决策，并促进以患者为中心的沟通，在TM和IP咨询。我们的数据表明，尽管物理分离，医生与患者的沟通，在TM并不逊色于IP协商期间的沟通。
The quality of physician-patient communication is a critical factor in treatment outcomes and patient satisfaction with care. To date, few studies have specifically conducted an in-depth evaluation of the effect of telemedicine (TM) on physician-patient communication in a medical setting. Our objective was to determine whether physical separation and technology used during TM have a negative effect on physician-patient communication. In this noninferiority randomized clinical trial, patients were randomized to receive a single consultation with one of 9 physicians, either in person (IP) or via TM. Patients (n = 221) were recruited from pulmonary, endocrine, and rheumatology clinics at a Midwestern Veterans Administration hospital. Physician-patient communication was measured using a validated self-report questionnaire consisting of 33 items measuring satisfaction with visit convenience and physician's patient-centered communication, clinical competence, and interpersonal skills. Satisfaction for physician's patient-centered communication was similar for both consultation types (TM = 3.76 versus IP = 3.61), and noninferiority of TM was confirmed (noninferiority t-test p = 0.002). Patient satisfaction with physician's clinical competence (TM = 4.63 versus IP = 4.52) and physician's interpersonal skills (TM = 4.79 versus IP = 4.74) were similar, and noninferiority of TM was confirmed (noninferiority t-test p = 0.006 and p = 0.04, respectively). Patients reported greater satisfaction with convenience for TM as compared to IP consultations (TM = 4.41 versus IP = 2.37, noninferiority t-test p < 0.001). Patients were equally satisfied with physician's ability to develop rapport, use shared decision making, and promote patient-centered communication during TM and IP consultations. Our data suggest that, despite physical separation, physician-patient communication during TM is not inferior to communication during IP consultations.