Background

Observation studies are used in health care research, e.g. to explore behaviors of patients or health care professionals in hospitals. A methodological challenge in observation studies is the observer effect, as it can jeopardize the quality of a study.

Objectives

To capture different dimensions of the observer effect through health care professionals' and patients' experiences, and their reactions to being observed in a hospital setting, and in addition, observers' experiences from performing an observation study.

Method

Four focus group interviews (health care professionals and observers) and 10 individual interviews (patients) were conducted with participants from a Norwegian observation study focusing on medication communication at a hospital ward. In all 26 persons were interviewed, whereof 3 were observers (pharmacist, pharmacy students). Data were collected between September 2019 and January 2020 and analyzed by an inductive, thematic analysis approach.

Results

Five main themes were identified; Experiencing being observed; Temporarily adapting medication communication behavior; Consequences for the patients; To interact or not - reflections on the relations and Observing the observers. Respondents reported some observer effects, but also that these diminished with time. Even though minimal interaction was used as a strategy, observers and the observed still built rapport.

Conclusions

The observer effect in relation to medication communication seemed to be small and temporary in this specific hospital setting, among other things as staff and patients were used to extra persons (e.g. students) being around. Medication communication in hospital settings is a complex behavior, and appears to not be strongly impacted by the presence of observers, especially with a long observation time. It is important for researchers to monitor and record the observer effect in the specific setting of the study. This can be done by interviews with the observed and the observers by someone not connected to the observation study.

中文翻译：

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医院环境中的观察者效应 - 观察者和观察者的经验

背景

观察研究用于医疗保健研究，例如探索医院中患者或医疗保健专业人员的行为。观察研究中的一个方法挑战是观察者效应，因为它会危及研究的质量。

目标

通过医疗保健专业人员和患者的经历，以及他们对在医院环境中被观察的反应，以及观察者在进行观察研究中的经历，来捕捉观察者效应的不同维度。

方法

与来自挪威观察研究的参与者进行了四次焦点小组访谈（医疗保健专业人员和观察员）和 10 次个人访谈（患者），重点是医院病房的药物交流。共采访了 26 人，其中 3 人为观察员（药剂师、药学学生）。数据是在 2019 年 9 月至 2020 年 1 月期间收集的，并通过归纳的主题分析方法进行分析。

结果

确定了五个主要主题；经历被观察；临时调整用药沟通行为；对患者的后果；交互与否 - 对关系的反思和观察观察者。受访者报告了一些观察者效应，但这些效应随着时间的推移而减弱。尽管使用最少的互动作为一种策略，但观察者和被观察者仍然建立了融洽的关系。

结论

在这种特定的医院环境中，与药物交流有关的观察者效应似乎很小且是暂时的，其中工作人员和患者习惯于周围有额外的人（例如学生）。医院环境中的药物交流是一种复杂的行为，并且似乎不会受到观察者在场的强烈影响，尤其是在观察时间较长的情况下。对研究人员来说，在研究的特定环境中监测和记录观察者效应非常重要。这可以通过与观察研究无关的人采访被观察者和观察者来完成。