Understanding how mothers conceive of their children's illness: a key to doctor-patient communication

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.