Analysed interaction in a children's oncology clinic: the child's view and parent's opinion of the effect of medical encounters.

Every effort is made to provide children affected by cancer-related illness with advanced medical care. This theory-developing, hypotheses-generating study focused on the child's view of the service provided in an oncology clinic. The methodology included interviews, observations of medical consultations and children's drawings. It also sought the parents' opinion of the effect of an impending appointment on the child's behaviour. The population for this ideographic research consisted of a convenience sample of 10 children over the age of 5 years, attending an oncology clinic which served a medium-sized city and its surrounding area. Quantitative and qualitative data were collected from semi-structured interviews, participant observations, transcribed audio-tape recordings and gaze interaction charts. Data were analysed using grounded theory. The medical interview was not acknowledged as being very significant by the children: their conscious attention centred on peers and play activities. The data also suggest that clinic visits are more acceptable for children when staff invest personal attention, give appropriate adequate explanations and handle children sensitively. Behaviour changes before appointments were reported by parents to be more prevalent in children who received less positive regard from the health team. Clinic observations and transcripts demonstrated the doctor's 'dominant role' during consultations. Interaction with the child centred around the examination and was frequently interrupted. A more extensive study would confirm or refute these provisional findings.