Seven distinct coding approaches were applied to one audiotaped consultation. Only exchanges related to deprescribing a benzodiazepine (BZD) were coded for: content, interaction, arguments, connectors, transitions, orientation towards deprescribing and concordance with a deprescribing algorithm. A discursive map presents the unfolding of the exchanges.
The deprescribing conversation was broken down into 31 utterances divided into three segments: opening (n = 6), development (n = 16) and closing (n = 9). The family physician dominated the last two segments and most of her utterances were favorable to BZD deprescribing while the patient\'s utterances were generally unfavorable in the first two segments. The number of distinct codes assigned to utterances varied according to the coding approach. The map illustrates how each utterance can be viewed through different lenses revealing the dynamics and complexity of the deprescribing conversation.
This multidimensional methodological approach with its proposed way of presenting results, either quantitatively or qualitatively, and its map offer a comprehensive evaluation of the deprescribing process in this PC setting.
This novel multidimensional coding approach has potential to be applied to a range of other topics in clinical communications.
七种不同的编码方法被应用于一个录音咨询。仅对与停用苯二氮卓类药物(BZD)有关的交流进行了编码:内容,互动,arguments,连接器,过渡,朝向去处方和与去处方算法的一致性。话语地图展示了交流的展开。
令人沮丧的对话分为31个话语,分为三个部分:开场(n=6),发展(n=16)和关闭(n=9)。家庭医生主导了最后两个部分,她的大多数话语有利于BZD的开药,而患者的话语在前两个部分通常是不利的。分配给话语的不同代码的数量根据编码方法而变化。该地图说明了如何通过不同的镜头来查看每个话语,从而揭示了令人沮丧的对话的动态和复杂性。
这种多维方法论方法及其提出的呈现结果的方式,定量或定性,和它的地图提供了一个全面的评估在这个PC设置的处方过程。
这种新颖的多维编码方法有可能应用于临床通信中的一系列其他主题。