Pediatrician-parent-child communication: problem-related or not?

Pediatricians are generally confronted with a variety of health problems. Each of these problems may benefit from another pattern of healthcare communication. It is unknown whether the communication process during pediatric visits actually differs by the nature of the child's problem. This study first examined whether three formerly identified communication patterns could be distinguished within real-life pediatric outpatient encounters (N=846). Then, communication patterns during encounters with children with respiratory (n=269) or behavioral problems (n=77) were compared. Videotaped visits were observed using the Roter Interaction Analysis System. Two-level multivariate logistic regression analysis examined what factors contributed to the communication patterns. A biopsychosocial communication pattern was observed in 45%, a psychosocial in 15% and a biomedical pattern in 40% of the visits. Child's age and pediatrician's experience were related to the communication pattern. Different patterns did indeed prevail in respiratory and behavioral problems. As less experienced pediatricians attend to psychosocial issues less, they may have to be specifically encouraged to do so.