Abstract:Internet-based medical treatment is a medical practice actively encouraged by the state, of which online doctor-patient communication is an important part. During the COVID-19 pandemic, online doctor-patient communication has received wide attention and become an important medical option for the public. Based on in-depth interviews with online doctors and patients, according to the key roles of doctors and patients and the participation degree of patients, online doctor-patient communication can be categorized into four types: paternalistic style, consumption style, consultation style, and negotiation style. The paternalistic communication is very much like the traditional offline doctor-patient relationship, which is doctor-dominated, disease-centered, and problem-solving-oriented, and involves low participation of patients. The consumption style is also disease-centered, but patients are more actively involved in communication, and thus more important in the doctor-patient power relation. The consultation style is patient-centered, emphasizing medical humanism, doctor-patient communication and doctor-patient relationship. The negotiation style is an ideal equal doctor-patient communication. It is patient-centered and involves high patient participation. Online doctor-patient communication improves the effect of consultation and diagnosis. The effects of online consultation resulting from different doctor-patient communication modes are different. The major differences lie in patient satisfaction, curative effect, improvement of the patient's health and healthy behaviors, while the patient's expectations, the doctor's changes, technology empowerment and Internet environment are the specific mechanisms that result in the difference in the effects of consultation.
[1] 吴江,刘冠君,胡仙.在线医疗健康研究的系统综述:研究热点、主题演化和研究方法[J].数据分析与知识发现,2019,3(4):2-12. [2] 国家卫健委:疫情期间一些第三方互联网医疗服务平台诊疗咨询量比同期增长20多倍[EB/OL]. http://n.eastday.com/pnews/1584691745017338, 2020-03-20. [3] 在线医疗行业数据分析:预计2020年4月中国在线医疗用户规模将达5900万人[EB/OL].https://www.iimedia.cn/c1061/69331.html,2020-02-26. [4] 刘国旗. “使用与满足”视角下的“春雨医生”APP知识共享研究[D].合肥:安徽大学,2016. [5] May C.The clinical encounter and the problem of context[J].Sociology,2007,41(1):29-45. [6] 马骋宇. 在线医疗社区服务利用及转化研究——以好大夫在线为例[J].中国卫生政策研究,2016,9(11):70-73. [7] 邵双,刘芬,袁玉婷,杨中华.我国在线医疗信息服务平台现状分析——以39健康网、寻医问药网和好大夫在线为例[J].现代商贸工业,2014,26(7):162-164. [8] 柴民权. 我国医患关系的人际-群际嬗变——兼论“师古方案”的可行性[J].南京师大学报(社会科学版),2017,(2):112-118. [9] Emanuel E J,Emanuel L L.Four models of the physician-patient relationship[J].JAMA, 1992, 267(16): 2221-2226. [10] Walther,J. B.,Parks,M. R.Cues filtered out, cues filtered in:Computer-mediated communication and relationships[J].Handbook of interpersonal communication,2002,(3): 529-563. [11] Gordon H S,Street R L.How physicians, patients,and observers compare on the use of qualitative and quan-titative measures of physician-patient Communication[J].Evaluation & the Health Professions, 2016,39(4):496-511. [12] Jaffe,J.M.,Lee,Y.,Huang,L.,Oshagan,H.Gender, pseudo-nyms,and CMC:Masking identities and baring souls[C]. New Mexico:45th Annual Conference of the International Communication Association, 1995. [13] 施立. 在线医疗社区激励机制对医生交流情感影响研究[D].武汉:武汉大学硕士论文,2018. [14] Chester A,Glass C A .Online counselling: a descriptive analysis of therapy services on the Internet[J].British Journal of Guidance & Counselling,2006,34(2):145-160. [15] Roter D L.The enduring and evolving nature of the patient-physician relationship[J].Patient Education and Counseling, 2000, 39(1): 5-15. [16] Street R L, Makoul G,Arora N K, et al.How does communication heal?Pathways linking clinician-patient communication to health outcomes[J].Patient Education and Counseling,2009,74(3):295-301. [17] 潘绥铭,姚星亮,黄盈盈.论定性调查的人数问题:是“代表性”还是“代表什么”的问题——“最大差异的信息饱和法”及其方法论意义[J].社会科学研究,2010,(4):108-115. [18] Slingsby B T,Yamada S,MPH, et al. Four physician communication styles in routine Japanese outpatient medical encounters[J].Journal of General Internal Med-icine,2006,21(10):1057-1062. [19] Roter D L,Stewart M,Putnam S M, et al.Communication patterns of primary care physicians[J].JAMA,1997,277(4):350-356. [20] Cline R J.At the intersection of micro and macro: Opportunities and challenges for physician-patient communication research[J].Patient Education and Coun-seling,2003,50(1):13-16. [21] Chen,Yun-Ju.E-health:transforming the physician/patient relationship[J].International Journal of Medical Informa-tics,2001,61(1):1-10. [22] Epstein R,Franks P,Fiscella K,et al.Measuring patient-centered communication in patient-physician consul-tations: theoretical and practical issues[J].Social Science & Medicine,2005,61(7):1516-1528. [23] Charles C, Gafni A,Whelan T J, et al.Shared decision-making in the medical encounter:What does it mean? (or, it takes at least two to tango)[J].Social Science & Medicine,1997,44(5):681-692. [24] Yang,H.,Guo,X.,Wu,T.Exploring the influence of the online physician service delivery process on patient satisfaction[J].Decision Support Systems,2015,78:113-121. [25] Hagiwara N,Kashy D A,Penner L A.A novel analytical str-ategy for patient-physician communication research: The one-with-many design[J].Patient Education & Counseling,2014,95(3):325-331. [26] Xiang J, Stanley S J.From online to offline: Exploring the role of e-health consumption, patient involvement, and patient-centered communication on perceptions of health care quality[J].Computers in Human Behavior,2017, 70:446-452. [27] Broom A.Virtually he@lthy:The impact of internet use on disease experience and the doctor-patient relati-onship[J].Qualitative Health Research,2005,15(3):325-345. [28] Whitney S N, Mcguire A L,Mccullough L B, et al.A typology of shared decision making,informed consent,and simple consent[J].Annals of Internal Medicine,2004,140(1):54-59. [29] 李宁,黄健.网络环境下医患人际传播的困境探究[J].东南传播,2018,(7):93-95. [30] Finset A.Research on person-centred clinical care[J]. Journal of Evaluation in Clinical Practice,2011,17(2): 384-386. [31] Loh A,Simon D,Wills C E,et al.The effects of a shared decision-making intervention in primary care of depression: A cluster-randomized controlled trial[J]. Patient Education & Counseling,2007,67(3):324-332.