Use of a computer to take booking histories in a hospital antenatal clinic. Acceptability to midwives and patients and effects on the midwife-patient interaction.

An interactive computer system was used by midwives to acquire a full patient history at the first antenatal visit. The clinical efficacy of the system had been previously established. The present evaluation examined the effects of computer use on the interview process and on midwife-patient communications, and its acceptability to midwives and patients. Data included video recordings of 32 conventional interviews and of 63 interviews in which the computer was used, each with associated questionnaires assessing patients' reactions. Midwives' views were obtained through a structured discussion session. Computer use had no effects on patients' reactions to the interview, and midwives were enthusiastic. Detailed analysis of the video recordings using established quantitative techniques did not reveal any negative psychologic effects that would preclude the use of nurse-patient interactive computers. However, midwives were inclined to give less information to patients, especially when they were new to the computer, and to use more closed questions and leading questions. The findings have important implications for the future use of similar computer systems. These are presented in the form of guidelines for future systems design and implementation.