Exploring Origins of Patient Post-Encounter Perceptions

探索患者遭遇后看法的起源

• 批准号: 7106098
• 负责人: PETER ADAM KELLY
• 金额: $ 5万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2008-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7106098
• 关键词: clinical research; health services research tag; human subject; paralinguistic behavior; patient care personnel relations

DESCRIPTION (PROVIDED BY APPLICANT): The objective of this project is to analyze moment-by-moment the verbal and non-verbal communication that occurs between physician and patient during a medical encounter, as well as patients' perceptions of this communication. In our analysis, we intend to uncover recurring patterns of moment-by-moment verbal and non-verbal acts that trigger patients' overall perceptions of their physician and the medical encounter. To date, "conventional" physician-patient communication research has been limited to comparison of patients' overall perceptions with overall totals of communication acts tallied from an entire medical encounter (up to 25-30 minutes in length). We will shift the focus of analysis to a micro level of detail by employing postencounter stimulated recall, an adaptation of a measurement technique used for many years in other fields of research. The general conceptual model of physician-patient communication, that is, effective communication leading to improved patient perceptions, to better patient self-monitoring behaviors and ultimately to improved patient health outcomes, has come to be accepted as working theory in the medical and communication sciences. Therefore, physicians and patients stand to increase desirable patient physiological outcomes by understanding what drives the moment-by-moment evolution of patients' perceptions and by recognizing the specific verbal and non-verbal acts that are most often associated with the emergence of those perceptions. We posit that the application of post-encounter stimulated recall to physician-patient communication research will provide researchers new information that may help them identify in physician-patient encounters "moments that make a difference" in patient outcomes. We propose to execute this project in three phases, corresponding to the following specific aims: Specific Aim 1) To test a computer-based technique for administering post-encounter stimulated recall, ensuring that patients are able to use the system as intended; Specific Aim 2) To develop and test the reliability of a communication coding system for non-verbal acts that focuses on the same constructs of physician-patient communication as an existing system for verbal acts; Specific Aim 3) To demonstrate that verbal and non-verbal acts specifically identified by patients as driving their perceptions of physician and medical encounter predict patients' overall post-encounter perceptions better than "conventional" overall totals of acts do.

描述（由申请人提供）：本项目的目的是分析每时每刻的口头和非口头沟通，发生在医生和病人之间的医疗遭遇，以及病人的看法，这种沟通。在我们的分析中，我们打算揭示每时每刻的语言和非语言行为的重复模式，这些行为触发了患者对他们的医生和医疗遭遇的整体看法。迄今为止，“传统的”医患沟通研究仅限于将患者的总体感知与整个医疗过程（长达25-30分钟）中记录的总体沟通行为进行比较。我们将通过使用计数器后刺激回忆（postencounter stimulated recall），将分析的重点转移到微观层面的细节上，这是一种在其他研究领域使用多年的测量技术。医患沟通的一般概念模型，即有效的沟通导致改善患者的感知，更好的患者自我监控行为，并最终改善患者的健康结果，已被接受为医学和传播科学的工作理论。因此，医生和患者站在增加期望的患者生理结果，通过理解是什么驱动患者的感知的每时每刻的演变，并通过识别最经常与这些感知的出现相关联的特定的语言和非语言行为。我们认为，应用后接触刺激回忆医患沟通研究将提供研究人员新的信息，可能有助于他们确定在医患接触的“时刻，使不同的”病人的结果。我们建议分三个阶段执行这个项目，对应于以下具体目标：具体目标1）测试一种基于计算机的技术，用于管理遭遇后刺激回忆，确保患者能够按预期使用该系统;具体目标2）开发和测试非语言行为的通信编码系统的可靠性，该系统关注与医生相同的结构，患者沟通作为一个现有的系统，为口头行为;具体目标3）证明，口头和非口头行为，特别是由患者确定为驱动他们的看法，医生和医疗遇到预测患者的整体后，遇到的看法比“传统”的总体行动做。