Communicating psychosocial problems in German well-child visits. What facilitates, what impedes pediatric exploration? A qualitative study.

OBJECTIVE

To examine whether, and if so, how psychosocial topics are discussed between parents and pediatricians.

METHODS

Thirty well-child visits at eight pediatricians' practices in southwest Germany were video recorded. Conversations were analyzed.

RESULTS

Although psychosocial topics were frequently touched upon, they were rarely thoroughly explored. Pediatricians pursued a rather reserved conversation style. Especially when parents withdraw and psychosocial stressors are less baby-related, pediatricians hardly explore the psychosocial situation.

CONCLUSION

In summary, the pediatrician's conversation style, the nature of the stressors and the parents' openness are paramount in determining the depth of psychosocial exploration.

PRACTICE IMPLICATIONS

In order to ensure a good and fair quality of care to all parents, pediatricians should be provided with tailored communicative skills training allowing them to create a climate in which parents may open up and build trust toward their pediatrician.