Pediatrician-Parent Communication in a Continuity-of-care Setting

Abstract

This study investigated pediatrician-parent communication by content, analyz ing medical encounters in a setting providing continuity of care. Thirty-eight encounters between middle class families and three senior pediatricians were au dio-taped, transcribed, and analyzed for content. The categories of medical com munication coded from the interactions were related to each family's medical and demographic characteristics. Five patterns of results emerged: (1) There was a highly stylized active-passive role relationship, with doctors asking twice as many questions and making twice as many commands as the parents did. (2) A strong reciprocity norm existed between pediatricians and parents for the communication of affect. (3) The higher the experience, income, and educational levels of the parents, the shorter the encounters were, the less frequently symptoms were dis cussed, and the more frequently medication and professional treatment were men tioned. (4) Parents discussed health more in terms of organicity of causes than did pediatricians who, more frequently, raised environmental factors. (5) The more the family had a history of past illnesses, the more frequently the doctors made affect comments during the encounters. Comparing the results to findings drawn from an emergency clinic documented the importance of sustained relationships between practitioners and patients.