A pilot study of observed physician–parent–child communication and child satisfaction in a gastroenterology clinic

Figures & data

Table 1 Physician, parent, and child communication codes

Communication codes	Example
Physician/parent affective communication
Rapport (sum)
Concern	“I’m worried”
Empathy/legitimize	“It’s natural to be concerned”
Reassurance	“Great news! Your weight is up!”
Self-disclosure	“I’ve had a colonoscopy myself”
Chit-chat	“It’s a tough time to be a Phillies fan”
Joke	“I see butts all day”
Physician/parent interference
Interference (sum)
Interrupts child	(Adult interrupts child)
Fails to respond to child’s question/concern/comment	(Adults ignore child question or comment)
Answers a physician’s question that was directed to child (parent only)	(Parent answers a question directed to child, before child has opportunity to respond)
Physician/parent facilitative communication
Asks the child a question	“What kinds of foods do you eat”?
Partnership (sum)
Solicits questions from child	“Do you have any questions”?
Asks child for opinion/permission	“Is it ok if I listen to your belly”?
Checks for child understanding	“It’s going to take 1 minute, okay”?
Encouraging child response	“Mmm-huh,” “right”
Check self-understanding (of what child has said)	“You say pain is worse with spicy foods”?
Partnership building statements	“Let me know how I can help”
Child/teen communication
Child verbal participation (sum)
Asks a question	“Do I have to stop eating Cheetos”?
Checks self-understanding (of what physician/parent has said)	“So you’re going to put a camera up my butt”?
Gives information	“I play football”
Expresses opinion	“I don’t like the diarrhea”
Shows agreement or understanding	“Okay, I see”
Compliment (of 3rd party)*	“The cafeteria makes great food”
Approval	“I couldn’t have done it without you”
Concern/self-criticism	“But I can’t swallow pills”
Empathy/legitimize*	“I see how that’s difficult”
Reassurance/optimism	“I’ll be able to eat better”
Disapproval	“I thought you said I wouldn’t need shots”
Criticism (of 3rd party)	“Right, like I can afford that”
Check that physician/parent understands	“You know what I mean”?
Chit-chat	“I hope I am better by the big game next weekend”!
Joke	“I might blow away in a strong wind”!
“Don’t know” response	“I don’t know”

Note:

* Did not occur in our sample.

Table 2 Participant and visit characteristics

Variable	N (%) or Mean (SD, range)
Patient characteristics
Male	18	46
Female	21	54
Age (years)	11.7	(2.81, 8–17)
White/Caucasian	22	56
Hispanic or Latino	5	13
Black or African American	8	21
Asian/Pacific Islander	3	8
Other ethnicity	2	5
Parent highest education
High school	8	22
Trade/technical/vocational	3	8
College	18	49
Graduate degree	8	22
Visit characteristics
Mother present	37	95
Father present	11	30
Sibling present	5	13
New patient visit	15	39
Follow-up visit	24	62
Duration of visit (minutes)	24.5	(11.2, 5–56)

Table 3 Physician, parent, and child communication descriptive

Communication categories	Mean (SD, range)
Physician
Rapport (sum)	8.5 (5.4, 0–20)
Chit-chat	13.0 (9.3, 0–39)
Joke	1.6 (2.3, 0–10)
Interference (sum)	0.4 (0.6, 0–2)
Partnership (sum)	13.9 (12.1, 0–50)
Asks child question	24.9 (17.3, 0–68)
Parent
Rapport (sum)	2.1 (3.1, 0–12)
Chit-chat	5.7 (7.3, 0–36)
Joke	1.7 (2.1, 0–9)
Interference (sum)	2.5 (3.0, 0–14)
Partnership (sum)	2.3 (2.6, 0–10)
Asks child question	2.5 (2.9, 0–10)
Child
Child verbal participation (sum)	49.3 (32.5, 6–142)
Asks a question	2.5 (3.3, 0–12)
Checks self-understanding (of what physician/parent has said)	0.1 (0.2, 0–1)
Gives information	27.4 (21.2, 0–77)
Expresses opinion	0.9 (1.2, 0–4)
Shows agreement or understanding	2.8 (3.2, 0–12)
Compliment (of 3rd party)	0.0 (0.2, 0–1)
Approval	0.3 (0.6, 0–3)
Concern/self-criticism	0.4 (1.0, 0–4)
Empathy/legitimize	0.0 (0, 0–0)
Reassurance	0.1 (0.22, 0–1)
Disapproval	1.6 (3.7, 0–16)
Criticism (of 3rd party)	0.3 (0.2, 0–1)
Check that physician/parent understands	0.2 (1.1, 0–7)
Chit-chat	12.1 (12.5, 0–51)
Joke	1.1 (2.7, 0–14)
“Don’t know” response	1.1 (1.9, 0–10)