背景:获取医疗资源在中国一直是一个具有挑战性的问题,特别是那些不住在大城市的人。在线“问医生”(AtD)服务正在迅速普及。在AtDs上,病人或他们的照顾者可以向医疗专业人员提问,并接受医疗建议,而不需要拜访当地医院或医生办公室的麻烦。然而,该工具的通信模式和剩余的挑战是研究不足。
目的:本研究的目的是(1)探索中国ATD服务中患者与医生之间的对话模式,(2)在这种新的沟通形式中确定问题和剩余的挑战。
方法:我们进行了一项探索性研究,以分析患者与医生之间的对话以及患者的评论。为了分析对话数据,我们从语篇分析中获得灵感,并专注于对话的各个组成部分。我们还使用主题分析来发现嵌入在每个对话中的潜在主题,并确定患者投诉的主题。
结果:我们确定了患者和医生之间对话的四个阶段,包括启动阶段,继续阶段,结束阶段,和后续阶段。我们还总结了前三个阶段的常见模式和发送后续消息的原因。此外,我们确定了AtD服务的6个独特挑战,包括(1)初始阶段的低效沟通,(2)结束阶段未完成的谈话,(3)患者认为通信是实时的,不是医生,(4)语音留言的弊端,(五)违法行为的边缘,(6)咨询不值得支付。
结论:AtD服务提供了后续沟通模式,被认为是中国传统保健的良好补充。然而,几个障碍,比如道德问题,不匹配的看法和期望,成本效益问题仍需进一步调查。
Accessing medical resources has been a challenging issue in
China, particularly for people who do not live in big cities. Online \"Ask the doctor\" (AtD) services are gaining popularity rapidly. On AtDs, patients or their caregivers can ask questions to medical professionals and receive medical advice without going through the hassles of visiting local hospitals or doctors\' offices. However, the communication patterns and remaining challenges of this tool are understudied.
The purpose of this study was to (1) explore the dialogue patterns between the patients and the doctors on an AtD service in
China, (2) identify issues and remaining challenges in this new form of communication.
We conducted an exploratory study to analyze the dialogues between patients and doctors as well as patients\' reviews. To analyze the dialogue data, we took inspiration from the discourse analysis and focus on the various components of the dialogues. We also used thematic analysis to discover the underlying themes embedded in each dialogue, and identify themes from patient complaints.
We identified four stages in the dialogues between the patients and doctors, including the initiating stage, continuing stage, ending stage, and following up stage. We also summarized the common patterns in the first three stages and reasons for sending follow-up messages. Moreover, we identified 6 unique challenges of the AtD service, including (1) inefficient communication in the initial stage, (2) unfinished conversation in the ending stage, (3) communication is perceived as real-time by the patients, not by the doctors, (4) drawbacks of voice messages, (5) verge of the illegal behaviors, and (6) consultation is not worth the payment.
The AtD service provides the follow-up communication pattern which is considered as a good supplement of Chinese traditional health care. However, several barriers, such as ethical problems, mismatched perceptions and expectations, cost-effectiveness issue still need further investigation.