Patient-Provider Communication during the Emergency Department Care of Children with Asthma

Lawrence S. Wissow, Debra Roter, Laurie J. Bauman, Ellen Crain, Carolyn Kercsmar, Kevin Weiss, Herman Mitchell, Beth Mohr

Research output: Contribution to journalArticle

143 Citations (Scopus)

Abstract

OBJECTIVES. Poor children's reliance on emergency facilities is one factor implicated in the rise of morbidity attributed to asthma. Although studies have examined doctor-patient communication during routine pediatric visits, little data are available about communication during emergency care. This study sought to describe communication during emergency treatment of childhood asthma to learn if a "patient-centered" provider style was associated with increased parent satisfaction and increased parent and child participation. METHODS. This cross-sectional, observational study examined 104 children aged 4 to 9 years and their guardian(s) attending emergency departments in seven cities. Quantitative analysis of provider-family dialogue was performed. Questionnaires measured satisfaction with care, provider informativeness, and partnership. RESULTS. Providers' talk to children was largely supportive and directive; parents received most counseling and information. Children spoke little to providers (mean: 20 statements per visit versus 156 by parents). Providers made few statements about psychosocial aspects of asthma care (mean: three per visit). Providers' patient-centered style with parents was associated with more talk from parents and higher ratings for informativeness and partnership. Patient-centered style with children was associated with five times the amount of talk from children and with higher parent ratings for "good care," but not for informativeness or partnership. CONCLUSIONS. Communication during emergency asthma care was overwhelmingly biomedical. Children took little part in discussions. A patient-centered style correlated with increased parent and child participation, but required directing conversation toward both parents and children.

Original languageEnglish (US)
Pages (from-to)1439-1450
Number of pages12
JournalMedical Care
Volume36
Issue number10
StatePublished - Oct 1998

Fingerprint

Emergency Medical Services
Hospital Emergency Service
Asthma
Communication
parents
communication
Parents
rating
participation
Emergency Treatment
cross-sectional study
morbidity
Observational Studies
Counseling
counseling
Emergencies
conversation
Cross-Sectional Studies
childhood
dialogue

Keywords

  • Asthma
  • Children
  • Doctor-patient communication
  • Emergency care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nursing(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Wissow, L. S., Roter, D., Bauman, L. J., Crain, E., Kercsmar, C., Weiss, K., ... Mohr, B. (1998). Patient-Provider Communication during the Emergency Department Care of Children with Asthma. Medical Care, 36(10), 1439-1450.

Patient-Provider Communication during the Emergency Department Care of Children with Asthma. / Wissow, Lawrence S.; Roter, Debra; Bauman, Laurie J.; Crain, Ellen; Kercsmar, Carolyn; Weiss, Kevin; Mitchell, Herman; Mohr, Beth.

In: Medical Care, Vol. 36, No. 10, 10.1998, p. 1439-1450.

Research output: Contribution to journalArticle

Wissow, LS, Roter, D, Bauman, LJ, Crain, E, Kercsmar, C, Weiss, K, Mitchell, H & Mohr, B 1998, 'Patient-Provider Communication during the Emergency Department Care of Children with Asthma', Medical Care, vol. 36, no. 10, pp. 1439-1450.
Wissow LS, Roter D, Bauman LJ, Crain E, Kercsmar C, Weiss K et al. Patient-Provider Communication during the Emergency Department Care of Children with Asthma. Medical Care. 1998 Oct;36(10):1439-1450.
Wissow, Lawrence S. ; Roter, Debra ; Bauman, Laurie J. ; Crain, Ellen ; Kercsmar, Carolyn ; Weiss, Kevin ; Mitchell, Herman ; Mohr, Beth. / Patient-Provider Communication during the Emergency Department Care of Children with Asthma. In: Medical Care. 1998 ; Vol. 36, No. 10. pp. 1439-1450.
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