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ID naloge: 120 Letnik: 2002 Predmet: družinska medicina
Pristranost v porocanju o bolnikovih težavah
Avtor: Maja Klemencic, Alja Klešnik
Mentor: prof. dr. Igor Švab
IZHODIŠCA. Sposobnost pravilnega porocanja tega, kar je bolnik povedal, je kljucnega pomena v medicini. Zdravnikova interpretacija odraža ne samo, kar je bilo resnicno povedano, ampak tudi zdravnikovo videnje problema, nanjo vplivajo tudi razlicne okolišcine, v katerih se nahaja, osebnostne lastnosti. V raziskavi smo skušali ugotoviti, kakšne razlike obstajajo med interpretacijo bolnikovih težav in dejansko povedanim. Ob tem nas je zanimalo, ce pri tem pride do dodatne pridobitve ali opustitve informacij
HIPOTEZE. 1. med povedanim s strani bolnika in dejansko sporocenim obstajajo pomembne razlike. 2. del informacij se opusti, s strani posrednika se pojavijo nove.
3. dodane informacije pripomorejo k razumevanju bolnika.
METODE. V okviru mednarodne študije IMPROVE so bili opravljeni intervjuji z bolniki ( glavni pogoj vkljucitve je bila starost 70 do 80 ali vec kot 80 let ). Za potrebe te študije je bil uporabljen princip semi - strukturiranega vprašalnika. Vprašalniki so bili nato prepisani in kodirani ( dva neodvisna raziskovalca, racunalniški program ATLAS ). Intervjuje so izvajali študentje medicine, ki smo jim nato zastavili vprašanje: "Kaj ste si zapomnili iz intervjujev z bolniki?" Tudi ti intervjuji so bili prepisani in kodirani. Nato smo primerjali prepise ter kode v intervjujih z bolniki in anketarji.
REZULTATI. Po primerjavi prepisov pacientov s prepisi anketarjev smo informacije lahko razdelili v tri skupine: opušcene - tiste, ki se pojavijo v prepisih bolnikov, nikoli pa v prepisih anketarjev, dodane - ki se pojavijo le v prepisih anketarjev in usklajene - ki se pojavijo v prepisih anketarjev in bolnikov. Izdelali smo model, ki skuša pojasniti, kaj se dogaja z informacijami.
ZAKLJUCEK. Omenjene hipoteze smo potrdili. Med povedanim in dejansko sporocenim obstajajo razlike. Velik del informacij se res izgubi in pojavijo se nove, ki dejansko pripomorejo k boljšemu razumevanju.
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[Abstract / English version]
Pristranost v porocanju o bolnikovih težavah
Author: Maja Klemencic, Alja Klešnik
Mentor: prof. dr. Igor Švab
BACKGROUND. The abbility of reporting accuratelly what a patient has told is of vital importance in medicine. Doctor's interpretation reflects not only what was actually said, but also doctor's view of the problem, which is also influenced by certain aspects of the circumstances he is in at the moment or his personal characteristics. In the research we tried to asses the differences that exist between what the patient really said and the interpretation of his problem. We also wanted to know, if the information becomes omitted or added.
HYPOTHESIS. 1. there are important differences between what the patient says and what is actually communicated. 2. part of information is omitted and new information appear from the side of the mediator. 3. additional information increases understanding of the patient.
METHODS. A semi - structured questionaire has been used. The questionaires have been transcribed and coded ( by two independent researchers and the help of a computer programme ATLAS ). Afterwards the following question has been posed to the medical students, who have been involved as the interviewers: "What do you remember from the interviews with the patients?" These interviews were also transcribed and coded. The transcripts and the codes of the interviewers were compared with the transcripts of the patients.
RESULTS. After the comparison of the patient's transcripts with the transcripts of the interviewers, we could divide the data in the following three cathegories of information: omitted - the ones that appear in the transcripts of the patients, but never in the transcripts of the interviewers, added - the ones that appear only in the transcripts of the interviewers and agreed - they appear in the transcripts of the patients and interviewers. We have produced a model, that is trying to explain what is happening to the information in the process of communication.
CONCLUSIONS. We have confirmed the hypotheses. There are in fact differences between what is told and what is actually communicated. A big part of information is omitted and new information appear, that in fact do increase the understanding.
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