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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Evaluating provider communication in pediatric chronic kidney disease care using a global coding system.

Shayna S Coburn1, Wynne A Callon1, Michelle N Eakin1

  • 1Johns Hopkins University, School of Medicine, Division of Pulmonary and Critical Care Medicine, 5501 Hopkins Bayview Blvd, Baltimore, MD, 21224, United States.

Patient Education and Counseling
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PubMed
Summary

Effective communication is key for adolescents and young adults (AYAs) with chronic kidney disease (CKD). Provider communication skills were adequate but higher with female AYAs, suggesting areas for improvement, especially for males.

Keywords:
AdherenceAdolescentChildChronic illnessChronic kidney diseaseCodingCompliancePatient-centeredPatient-providerPediatricProvider communicationYoung adult

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Area of Science:

  • Pediatric Nephrology
  • Health Communication
  • Adolescent Medicine

Background:

  • Effective provider communication is crucial for adolescents and young adults (AYAs) with chronic illness, supporting patient-centered care during a critical developmental stage.
  • Communication dynamics in chronic illness care for AYAs remain understudied.
  • Understanding these dynamics is vital for improving healthcare experiences and outcomes for this population.

Purpose of the Study:

  • To describe provider communication skills during pediatric chronic kidney disease (CKD) care visits.
  • To determine if communication skills vary based on AYA characteristics such as age, gender, and race.

Main Methods:

  • Adapted a global consultation rating system for pediatric subspecialty care.
  • Analyzed audiotaped clinic encounters involving 18 pediatric nephrologists, 99 AYAs with CKD (stages 1-5), and 96 caregivers.
  • Hypothesized differences in communication skills based on AYA age, gender, and race.

Main Results:

  • Provider skills in initiating sessions and developing rapport were strongest.
  • Skills in asking for the patient's perspective and checking understanding were rated lowest.
  • Communication scores did not consistently differ by AYA age or race, but were higher for female AYAs in several domains (p<0.05).

Conclusions:

  • Pediatric providers generally demonstrated adequate to good communication skills with AYAs.
  • Enhancing specific communication skills, particularly with male AYAs, could further support patient-centered care.
  • Observation-based global assessment tools can identify areas for provider improvement to ensure consistent, patient-centered communication.