Children as patients: a communications process study in family practice

Area of Science:

• Pediatric Medicine
• Family Medicine
• Communication in Healthcare

Background:

• Understanding physician communication patterns with children is crucial for effective pediatric care.
• Previous research indicates limited direct communication between physicians and children during visits.

Purpose of the Study:

• To analyze how family physicians allocate attention between children and parents during pediatric encounters.
• To identify patterns in physician-child communication across different stages of a medical interview.

Main Methods:

• Analysis of 115 videotaped pediatric encounters involving children (4-14 years), parents, and family physicians.
• Observation of physician interaction with children and parents during diagnostic and treatment discussions.

Main Results:

• Physicians actively involved children in diagnostic stages but less in treatment discussions.
• Physician-child communication did not change with training level.
• Older children received more direct communication from physicians across all visit phases.

Conclusions:

• While communication with children has improved, greater involvement in all visit phases is warranted.
• A developmental approach suggests actively incorporating children in medical interviews supports their understanding of health and illness.
• Family medicine settings are well-positioned to implement enhanced child-centered communication strategies.