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Doctor-parent-child relationships: a 'pas de trois'
Kiek Tates1, Ed Elbers, Ludwien Meeuwesen
1Netherlands Institute for Health Services Research (Nivel), P.O. Box 1568, 3500 BN Utrecht, The Netherlands. k.tates@nivel.nl
Patient Education and Counseling
|September 11, 2002
Summary
In doctor-parent-child interactions, both doctors and parents often hinder child participation. This study reveals child disengagement is a co-construction, not solely adult-driven.
Area of Science:
- Pediatrics
- Communication Studies
- Medical Sociology
Background:
- Doctor-parent-child interactions are crucial in general practitioner (GP) settings.
- Child participation is often limited, with parents frequently speaking for the child.
- Existing literature highlights adult dominance in triadic medical consultations.
Purpose of the Study:
- To develop a typology of doctor-parent-child interactions.
- To classify adult behavior based on support for child participation.
- To describe child participation through involvement and seeking support.
Main Methods:
- Analysis of 105 video-recorded consultations.
- Classification of adult behavior (supportive vs. non-supportive).
- Description of child participation (involvement, turning for support).
Main Results:
- Most GPs and parents exhibited non-supportive behavior towards child participation.
- 90% of consultations concluded with low child participation, especially during diagnosis/treatment.
- Children showed minimal involvement and rarely sought parental support in later stages.
Conclusions:
- A bi-directional analysis enhances understanding of adult-dominated triadic medical interactions.
- Low child participation is a co-construction involving the child, parent, and doctor.
- Findings have pedagogical implications for improving child engagement in medical settings.