Becker Timothy D, Lin Henry C, Miller Victoria A
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Patient Prefer Adherence. 2018 Jul 26;12:1327-1335. doi: 10.2147/PPA.S171620. eCollection 2018.
Child participation in pediatric medical visits is low. In this pilot study, we sought to better understand relationships between observed communication and child-reported perceptions of communication in a clinical setting.
For this cross-sectional observational study, pediatric gastroenterology appointments (n=39) were videotaped and coded to quantify various adult affective (eg, chit-chat, empathy) and facilitative (eg, asking questions, encouraging responses) behaviors toward the child, interference with child participation (eg, interrupting or ignoring child), and child verbal participation. Post-visit surveys assessed child perceptions of having voice in the clinical encounter, ease of understanding, and satisfaction with communication.
Parent and provider chit-chat was associated with child-reported ease of understanding. Provider facilitation was positively associated with child participation, but affective communication strategies were not. Physician interference was negatively associated with ease of understanding but positively associated with perception of voice.
Facilitative communication may improve outcomes by enhancing child participation and thus exchange of medical information, whereas chit-chat appears to positively impact children's perceptions of communication.
儿童参与儿科就诊的程度较低。在这项试点研究中，我们试图更好地了解临床环境中观察到的沟通与儿童报告的沟通感受之间的关系。
对于这项横断面观察性研究，对儿科胃肠病学预约就诊（n = 39）进行录像并编码，以量化成人对儿童的各种情感行为（如闲聊、共情）和促进性行为（如提问、鼓励回应）、对儿童参与的干扰（如打断或忽视儿童）以及儿童的言语参与。就诊后调查评估了儿童对在临床交流中表达意见、理解难易程度以及沟通满意度的感受。
家长和医护人员的闲聊与儿童报告的理解难易程度相关。医护人员的促进性沟通与儿童参与呈正相关，但情感沟通策略并非如此。医生的干扰与理解难易程度呈负相关，但与表达意见的感受呈正相关。
促进性沟通可能通过增强儿童参与从而促进医疗信息交流来改善结果，而闲聊似乎对儿童的沟通感受有积极影响。
