Wassmer E, Minnaar G, Abdel Aal N, Atkinson M, Gupta E, Yuen S, Rylance G
Department of Paediatric Medicine, Birmingham Children's Hospital, Birmingham, United Kingdom.
Acta Paediatr. 2004 Nov;93(11):1501-6. doi: 10.1080/08035250410015079.
The outpatient clinic visit is the major focus of the hospital medical process for most paediatricians, children and parents. The importance of children as active participants in this interaction has been recognized. Our study aims are to describe and assess the components of doctor-parent-child communication in the outpatient setting.
Fifty-one medical paediatric clinic consultations were recorded on audio cassette, and communication was analysed according to quantitative methods. Questionnaires assessed parents' and children's perceptions.
Doctors contributed most to the conversation (61%), children only 4%. Behaviour: Doctors' communication was 84% instrumental (e.g. asking questions, giving information or instructions), 13% affective behaviour (expressing concerns and worries) and 3% social (small talk). Parents' communication included giving information (83%), seeking information (13%) and social (4%). The child asked less information (3%) and had more social conversation (19%).
Doctors dominated in turn taking (52%). Children took 9% of all turns. Perception: There was no correlation between parents' and children's perception and the informative or affective behaviour of the doctor.
Communication is mainly instrumental. Doctors tend to direct the interview. Children's contribution is small. The participation of children needs to be encouraged as part of a patient-centred approach.
门诊就诊是大多数儿科医生、儿童及其家长医院医疗过程的主要关注点。儿童作为这种互动中的积极参与者的重要性已得到认可。我们的研究目的是描述和评估门诊环境中医生-家长-儿童沟通的组成部分。
对51次儿科门诊会诊进行了录音，并根据定量方法对沟通进行了分析。通过问卷调查评估家长和儿童的看法。
在对话中医生的参与度最高（61%），儿童仅占4%。行为方面：医生的沟通中84%是工具性的（如提问、提供信息或指示），13%是情感行为（表达关切和担忧），3%是社交性的（闲聊）。家长的沟通包括提供信息（83%）、寻求信息（13%）和社交性的（4%）。儿童询问信息较少（3%），社交对话较多（19%）。
医生主导轮流发言（52%）。儿童占所有轮流发言的9%。看法：家长和儿童的看法与医生的信息性或情感性表现之间没有相关性。
沟通主要是工具性的。医生倾向于主导问诊。儿童的参与度较低。作为以患者为中心方法的一部分，需要鼓励儿童参与。
