Shayna S Coburn1, Wynne A Callon2, Michelle N Eakin3, Cozumel S Pruette4, Tammy M Brady5, Susan R Mendley6, Shamir Tuchman7, Barbara A Fivush8, Kristin A Riekert9. 1. Johns Hopkins University, School of Medicine, Division of Pulmonary and Critical Care Medicine, 5501 Hopkins Bayview Blvd, Baltimore, MD, 21224, United States. Electronic address: scoburn@childrensnational.org. 2. Johns Hopkins University, School of Medicine, Division of Pulmonary and Critical Care Medicine, 5501 Hopkins Bayview Blvd, Baltimore, MD, 21224, United States. Electronic address: wynne.callon@childrens.harvard.edu. 3. Johns Hopkins University, School of Medicine, Division of Pulmonary and Critical Care Medicine, 5501 Hopkins Bayview Blvd, Baltimore, MD, 21224, United States. Electronic address: Meakin1@jhmi.edu. 4. Johns Hopkins University, School of Medicine, Division of Pediatric Nephrology, 200 N. Wolfe Street, Baltimore, MD, 21287, United States. Electronic address: csouthe1@jhmi.edu. 5. Johns Hopkins University, School of Medicine, Division of Pediatric Nephrology, 200 N. Wolfe Street, Baltimore, MD, 21287, United States. Electronic address: tbrady8@jhmi.edu. 6. NIH/National Institute for Diabetes and Digestive and Kidney Diseases, Bethesda, MD, United States. Electronic address: susan.mendley@nih.gov. 7. Children's National Health System, Washington, DC Division of Nephrology, 111 Michigan Ave NW, Washington, D.C., 20010, United States. Electronic address: tuchman.shamir@gmail.com. 8. Johns Hopkins University, School of Medicine, Division of Pediatric Nephrology, 200 N. Wolfe Street, Baltimore, MD, 21287, United States. Electronic address: bfivush@jhmi.edu. 9. Johns Hopkins University, School of Medicine, Division of Pulmonary and Critical Care Medicine, 5501 Hopkins Bayview Blvd, Baltimore, MD, 21224, United States. Electronic address: kriekert@jhmi.edu.
Abstract
OBJECTIVE: Among adolescents and young adults (AYAs) with chronic illness, effective provider communication is essential for patient-centered care during a sensitive developmental period. However, communication in chronic illness care for AYAs is not well studied. Our objectives were to describe the provider communication skills in pediatric chronic kidney disease (CKD) care visits; and determine if communication skills differ by AYA characteristics. METHODS: We adapted a global consultation rating system for pediatric subspecialty care using audiotaped clinic encounters of 18 pediatric nephrologists with 99 AYAs (age M(SD) = 14.9(2.6)) with CKD stages 1-5 and 96 caregivers. We hypothesized that provider communication skills would differ by AYA characteristics (age, gender, and race). RESULTS: The strongest provider skills included initiating the session and developing rapport; lowest rated skills were asking patient's perspective and checking understanding. Communication scores did not consistently differ by AYA age or race, but were rated higher with female AYAs in several domains (ps<0.05). CONCLUSIONS: Pediatric providers generally had adequate or good communication scores with AYAs, but improvement in certain skills, particularly with male AYAs, may further support patient-centered care. PRACTICE IMPLICATIONS: To achieve consistent, patient-centered communication with AYAs, an observation-based global assessment may identify areas for provider improvement.
OBJECTIVE: Among adolescents and young adults (AYAs) with chronic illness, effective provider communication is essential for patient-centered care during a sensitive developmental period. However, communication in chronic illness care for AYAs is not well studied. Our objectives were to describe the provider communication skills in pediatric chronic kidney disease (CKD) care visits; and determine if communication skills differ by AYA characteristics. METHODS: We adapted a global consultation rating system for pediatric subspecialty care using audiotaped clinic encounters of 18 pediatric nephrologists with 99 AYAs (age M(SD) = 14.9(2.6)) with CKD stages 1-5 and 96 caregivers. We hypothesized that provider communication skills would differ by AYA characteristics (age, gender, and race). RESULTS: The strongest provider skills included initiating the session and developing rapport; lowest rated skills were asking patient's perspective and checking understanding. Communication scores did not consistently differ by AYA age or race, but were rated higher with female AYAs in several domains (ps<0.05). CONCLUSIONS: Pediatric providers generally had adequate or good communication scores with AYAs, but improvement in certain skills, particularly with male AYAs, may further support patient-centered care. PRACTICE IMPLICATIONS: To achieve consistent, patient-centered communication with AYAs, an observation-based global assessment may identify areas for provider improvement.
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