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Discharge communication in the emergency department : on quantity- and content-definition and on the benefit of information structuring

机译:急诊科的出院沟通:数量和内容定义以及信息结构的好处

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摘要

Health and diseases have always accompanied humans and are important topics to talk about. Appropriate communication, however, can only have an impact on one’s health if the essential content is transferred and if the message is sent in a way enabling the receiver to understand and recall it. Therefore, this cumulative dissertation has been realized to conduct four studies focusing on the quantity and content of information conveyed from the physician to the patient in the emergency department as perceived by both parties involved and in this context on the benefit of information structuring on the receiver’s subsequent recall capacity.udThrough the preliminary study, we could show that physicians from different specialties defined a large number of items as necessary to be given to a patient with chest pain at discharge from the emergency department. Study 1 revealed that physicians and patients strongly overlap in their assessment of what ought to be conveyed in a discharge communication: Nearly all items identified by the majority of physicians as important were also endorsed by the majority of patients. Three expert physicians classified the items chosen by the two groups into five exclusive categories, namely “Information on diagnosis”, “Follow-up suggestions”, “Advices on self-care”, “Red flags”, and “complete Treatment”, from which we generated the mnemonic acronym “InFARcT”.udAs experimentally tested in study 2 (using students as proxy patients), information structuring proofed to be beneficial in terms of the recall capacity of students with little to no prior medical knowledge: students in the structured condition recalled mean 8.12 items, whereas students in the non-structured condition recalled mean 5.71 items (p=0.004). Assuming that structure should benefit mostly those individuals who cannot make use of previous knowledge to build memory chunks and to better control the experimental setup between the two parameters “structure” and “prior knowledge”, we set out to oppose various degrees of relevant prior knowledge to structured and non-structured content presentation in study 3, with the following results: prior medical knowledge boosted recall performance – the group of students with the least prior knowledge recalled fewer items (M=7.11) than the group of students with intermediate prior knowledge (M=9.49), who in turn recalled fewer items than the group of students with most prior knowledge (M=13.23). Furthermore, the magnitude of the effects of information structuring seems to vary systematically by the degree of medical knowledge: It is greatest with least prior knowledge, and disappears gradually with increasing expertise.udWe conclude that there is an obvious need to train physicians in skills of implementing effective discharge communication, in content and form, as this represents a valuable and rare opportunity to communicate, and thereby to foster better outcomes. It should not go to waste.
机译:健康和疾病一直伴随着人类,并且是重要的话题。但是,适当的通信只有在基本内容被传输并且消息以使接收者能够理解和回忆的方式发送时,才会对人的健康产生影响。因此,已经实现了这一累积性论文,进行了四项研究,重点研究了当事双方都察觉到的,在急诊室中从医生传达给患者的信息的数量和内容,并且在这种情况下受益于接收者身体上的信息结构。通过初步研究,我们可以证明,来自不同专业的医生定义了急诊出院时胸痛患者需要给予的大量物品。研究1显示,医师和患者在评估出院沟通中应传达的内容方面存在很大的重叠:几乎所有被大多数医师确定为重要的项目也得到了大多数患者的认可。三位专家医师将两组选择的项目分为五个专有类别,分别是“诊断信息”,“随访建议”,“自我保健建议”,“危险信号”和“全面治疗”。 ud经研究2(使用学生作为代理患者)进行实验测试,证明信息结构对几乎没有医学知识或几乎没有医学知识的学生的回忆能力是有益的。结构化状态的回忆平均为8.12项,而非结构化状态的回忆平均为5.71项(p = 0.004)。假设结构应使那些无法利用先前知识来建立记忆块并更好地控制两个参数“结构”和“先前知识”之间的实验设置的人受益,我们开始反对各种程度的相关先验知识研究3中的结构化和非结构化内容呈现,具有以下结果:先前的医学知识可提高召回绩效–拥有较差先验知识的学生组回忆的项目(M = 7.11)要比具有中等先验知识的学生组的少(M = 9.49),反过来,他们回想起来的次数少于具有最先验知识的学生群体(M = 13.23)。此外,信息结构化影响的程度似乎会根据医学知识的程度而系统地变化:先验知识最少的情况下最大,而随着专业知识的增加逐渐消失。 ud我们得出结论,显然需要对医师进行培训在内容和形式上实施有效的排放沟通的技能,因为这代表了宝贵的,难得的交流机会,从而促进了更好的结果。它不应该浪费。

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    Ackermann Selina;

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  • 年度 2015
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  • 正文语种 {"code":"en","name":"English","id":9}
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