Let the Kid Speak: Dynamics of Triadic Medical Interactions Involving Pediatric Patients

ABSTRACT

Communication in healthcare represents the complex interplay between multiple individual and contextual factors unfolding over the course of the medical encounter. Despite significant improvements in patient-centered care delivery, studies of health communication typically focus exclusively on clinical interactions between adult patients and their clinicians. Much less is known about non-dyadic interactions, such as pediatric triads involving a child patient and accompanying parent. Understanding the dynamics of triadic pediatric healthcare communication is the first step toward evaluating and ultimately optimizing these healthcare interactions. Thus, we undertook a mixed-method analysis of 28 audio-recorded triadic medical interactions between healthcare providers, pediatric asthma and allergy patients, and their parents to explore the prevalence of various features of these interactions. Our findings point to mechanisms through which healthcare providers and parents may facilitate or hinder children’s involvement in their own asthma and allergy care, including interruptions, unclarified technical medical language, the flow of information exchange, and the formation of dyadic conversational partnerships (coalitions) between providers and parents. Our analyses further reveal that children’s participation during their medical visits was minimal (13% of the interaction). Providers in our sample elicited input directly from pediatric patients more often than from parents, though the difference was small. Taken together, these findings provide a foundation on which to develop training and communication interventions to ensure that children have a voice in their medical care.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. The male physician saw 16 patients total (13 male, 3 female patients). Of these 16 visits, both parents were present in 3 recorded interactions, followed by mother only in 12 interactions and father only in 1 interaction. The female nurse practitioner saw 12 patients total (8 male, 4 female patients). Of these 12 visits, both parents were present in one recorded interaction, followed by mother only in 7 interactions and father only in 4 interactions.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.