2001-06-05
org.kosen.entty.User@c3ffd94
김은정(OSTIN4)
발행기관
Rita M. Mangione-Smith
Context. Online commentary is talk that describes what physician is seeing, feeling, or hearing during physical examinaiton of the patient. Preliminary research suggests that this communicaiton technique might aid physicians in avoiding inappropriate antibiotic prescribing.
Objectives. To examine the relationship between online commentary use and the physician's prescribing decision.
Design. Pre-visit and post-visit survey of parents, post-visit survey of physicians, and audiotaping of encounters.
Setting. Two private pediatric practices.
Participants. 10 physicians(response rate = 77%); 306 eligible patents(response rate = 86%) who were attending sick visits for their children between 10/96 and 3/97.
Results. Physicians who used exclusively 'no problem' online commentary, e.g. "Her ears look prefect." prescribed antibiotics less often than physicians who used 'problematic' online commentary (45% versus 66% of cases ; p<.001).In viral cases, when physicians thought parents expected antibiotics, 'no problem' online commentary was exclusively used in 79% of cases where physicians resisted the pressure to prescribe antibiotics versus in only 29% of cases where physicians acquiesced to parental pressure to prescribe (p<.001).
Conclusions. 'No problem' online commentary use is a communication technique that may provide and effective and efficient method for resisting both explicit and perceived pressure to prescribe antibiotics.
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