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Video analysis of communication in paediatric consultations in primary care
Patricia Cahill1, Alexia Papageorgiou
1The Norwich Road Surgery, Ipswich, Suffolk. patriciacahill@doctors.org.uk
Insights
Children participate more in doctor visits when invited and when adult carers voice concerns later. This improves communication in pediatric primary care consultations.
Area of Science:
- Pediatric primary care
- Communication in healthcare
- Conversation analysis
Background:
- Limited research exists on communication dynamics in pediatric consultations involving general practitioners (GPs), adults, and child patients.
- Understanding these interactions is crucial for effective healthcare delivery to children.
Purpose of the Study:
- To identify key features of the interaction between a doctor, a child patient (aged 6-12 years), and their accompanying carer.
- To analyze the child's participation within the primary care consultation setting.
Main Methods:
- Qualitative analysis of 31 video-recorded primary care pediatric consultations.
- Utilized conversation analysis methodologies to examine interaction patterns.
- Study conducted in primary care settings in Suffolk, UK, involving 16 volunteer NHS GPs.
Main Results:
- Children demonstrated limited involvement in consultations unless explicitly invited to participate.
- Children took longer than adults to respond to doctor's questions.
- Adult carers were less likely to answer for the child when the doctor directly addressed the child.
- Carers interrupted doctor-child dialogue if they voiced their own concerns first.
- Triadic communication, involving all parties equally, was observed in a triangular seating arrangement.
Conclusions:
- Enhancing child involvement in primary care consultations is linked to adult carers voicing their concerns early.
- Inviting children to speak, using appropriate "recipient design" by doctors, facilitates greater child participation.
Background:
There is a paucity of research evidence concerning communication in paediatric consultations between GPs, adults, and child patients.
Aim:
This study was carried out to identify features of the interaction between a doctor, a child patient aged 6-12 years, and their carer in the consultation associated with the child's participation.
Design Of Study:
A qualitative analysis of video recordings of 31 primary care paediatric consultations was undertaken, using strategies from the methodology of conversation analysis.
Setting:
Primary care, Suffolk, UK.
Method:
NHS GPs from three primary care trusts (PCTs), were invited to participate in this study. Sixteen volunteers from this sample took part.
Results:
Analysis of the interaction in the consultations revealed that the children had little involvement. Children participated when invited to do so, and took more time than adults to answer a doctor's question. An adult carer was less likely to answer on behalf of a child, when they were in a position to see that the doctor's gaze was directed at the child, and the doctor addressed the child by name. Adult carers, who had not voiced their own concerns first, were seen to interrupt doctor-child talk. In consultations where the participants sat in a triangular arrangement, all parties being an equal distance apart, triadic talk was noted.
Conclusion:
Child involvement in the primary care consultation is associated with adult carers being able to voice their own concerns early in the consultation, and children being invited to speak with the appropriate recipient design.
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