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Doctor-child communication and caregivers' willingness to recommend hospital: a secondary analysis using pediatric

Hao Huang1, Weina Shang2, Ming Zhu3

  • 1Department of Medical Record Statistics, Xuanwu Hospital, Capital Medical University, Beijing, China.

Translational Pediatrics
|May 20, 2026
PubMed

Insights

Encouraging children to ask questions significantly boosts caregiver loyalty and hospital ratings. This child-centered communication practice is key to improving pediatric care quality and fostering family trust.

Area of Science:

  • Pediatric Healthcare
  • Communication Studies
  • Health Services Research

Background:

  • Doctor-child communication is vital in pediatrics but often overlooks child-centered interactions.
  • Existing research struggles to link specific communication behaviors to hospital performance metrics.
  • This study utilizes the Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) framework to analyze communication.

Purpose of the Study:

  • To deconstruct doctor-child communication into discrete behaviors using the Child HCAHPS framework.
  • To assess the distinct impact of these behaviors on caregivers' overall hospital ratings and recommendation willingness.
  • To clarify the relationship between triadic clinical interactions and patient loyalty.

Main Methods:

  • Retrospective multicenter analysis of cross-sectional survey data from the Chinese Child HCAHPS.
  • Inclusion of pediatric inpatients from six National Regional Centers for Pediatrics in China.
  • Ordinal logistic regression and path analysis to examine associations and mediation effects, adjusting for covariates.

Main Results:

  • Encouraging children to ask questions showed a significant positive association with overall hospital ratings (β=1.075) and willingness to recommend (β=1.382).
  • Child's perceived health status was a significant covariate for hospital ratings.
  • Path analysis indicated that overall hospital rating partially mediated the link between encouraging questions and recommendation willingness (indirect association β=0.338).

Conclusions:

  • Encouraging children's questions is a critical communication behavior that directly and indirectly enhances caregiver loyalty.
  • Empowering child participation is a core element of patient-centered care in triadic clinical settings.
  • Targeted training and system design focusing on child-centered communication are priorities for improving pediatric care quality and family trust.
Abstract

Keywords:
Physician-patient relationschildcommunicationpatient-centered care

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