Friend S H, Rostain A L
Pediatr Emerg Care. 1985 Jun;1(2):71-3.
In many ways, parents are the true consumers of their children's health care. How parents understand the cause, presentation, and treatment of their child's illness strongly affects doctor-patient communication, compliance in treatment, and follow-up. To better understand and enhance compliance, we have studied mothers' concepts of illness using Piaget's stages of cognitive development. Fifty-nine mothers who brought their children to the emergency department (ED) of a large urban children's hospital were asked, "How does a child get a cold," and "What makes a cold go away?" We directly transcribed answers and compiled information on maternal education, employment status, method of payment for health care, and number of children in the family. Forty-four percent of mothers had a prelogical conceptualization of illness, and only 17% had a formal-logical conceptualization. Only employment in the health care fields correlated with maternal conceptual levels regarding childhood illness. Physicians need to take care to communicate with the parent at her level of conceptualization to ensure understanding.
在很多方面，父母才是孩子医疗保健的真正消费者。父母对孩子疾病的病因、症状及治疗的理解程度，会对医患沟通、治疗依从性及后续跟进产生重大影响。为了更好地理解并提高依从性，我们运用皮亚杰的认知发展阶段理论研究了母亲们对疾病的认知概念。我们询问了59位带孩子前往一家大型城市儿童医院急诊科的母亲：“孩子是怎么感冒的？”以及“感冒怎样才能好？”我们直接记录了她们的回答，并收集了有关母亲教育程度、就业状况、医疗保健支付方式以及家庭子女数量等信息。44%的母亲对疾病持有前逻辑概念，只有17%的母亲有形式逻辑概念。只有从事医疗保健领域工作与母亲对儿童疾病的认知水平相关。医生需要注意根据母亲的认知水平与其沟通，以确保理解。
