Gaps in Doctor-Patient Communication: Doctor-Patient Interaction Analysis

Abstract

ExtractAs one of several approaches to scientific analysis of doc tor-patient communication, 285 visits to a pediatric walk-in clinic were scrutinized using an expanded version of Bales' Interaction Process Analysis. Data analysis consisted of individual case studies and computer programs for descriptive summaries of cases and index scores. Factor analysis and chi-squarc calculations were among the methods used to test significant relations between attributes of the doctor-patient interaction and the dependent variables, patient satisfaction, compliance, and demography.As hypothesized, a distinctive behavior pattern emerged for doctor, parent, and child. Doctors were found to talk more but show less emotion than mothers. Almost two-thirds of the mother's communication related to medical history, while the doctor discussed history and treatment but gave little attention to cause, prognosis, and seriousness. Although the physician expressed relatively little reassurance or friendliness to the mother, almost half of his conversation with the child consisted of friendly statements. In general, outcome of the medical consultation was found to be favorably influenced by having a physician who was friendly, expressed solidarity, took some time to discuss nonmedical, social subjects, and gave the impression of offering information freely without the patients having to request it or feeling excessively questioned. Speculation

Parent–provider communication and parental satisfaction with care of children with psychosocial problems

“…Those parents who were asked for their ideas in the treatment planning process were almost unanimously "very satisfied" with the care received and were 4 times more likely than those parents not involved to rate the quality of care as very high. The importance of effective collaboration or partnership with families was first identified by the pioneering work of Korsch and colleagues [40][41]. The use of collaboration is associated with a number of positive treatment outcomes.…”

Triadic communication in the primary care paediatric consultation: a review of the literature

“…This part takes place between the adults, with this distribution of child involvement seen in all the studies that reported this information. 19,21,[23][24][25][26]31,36 When a child was asked to present the problem for attendance, one of the studies suggested that this gave a child more opportunity to go on to have some participation in the latter part of the consultation. 23 It has also been shown that if the doctor and child start talking together at the outset of the consultation without the adult carer having had their concerns expressed, this is likely to result in the adult interrupting doctor-child talk.…”

“…[18][19][20][21]24,26,29,31,36 These studies use different methods to reach these estimates and so are not directly comparable with one another. However, they do show that the child has a limited quantifiable involvement in their own consultation.…”

“…Freemon et al 26 Quantitative descriptive study of Doctor-child communication was 12.5% Emergency children's 285 audiotaped consultations of the total interaction units hospital clinic, US Tannen and Wallat 27,28 A series of Jody's contribution is social, laughter and play Child development centre/US qualitative analyses of a doctor examining Mother's questioning interrupts the examination Jody aged 9, in the presence of her mother…”

“…[18][19][20][21][22][23][24][25] Thirteen papers on the paediatric triadic consultation in settings outside primary care, which met the criteria for inclusion, were found as shown in Table 2. [26][27][28][29][30][31][32][33][34][35][36][37][38] They are diverse in terms of the methodology used to evaluate the consultations, settings, and study designs. Eleven quantitative studies, nine qualitative studies, and one literature review of triadic paediatric consultation were found.…”