Communication patterns of primary care pediatricians, parents, and children with and without special health care needs

The purpose of this study was to compare the communication patterns of pediatricians with parents of children with special health care needs (CSHCN) and parents of healthy children to explore whether there were significant differences in communication patterns and satisfaction. Ten pediatricians were audiotaped during 97 outpatient medical encounters. Analyses of variance (ANOVAs) were used to examine communication patterns based on children's health status. Results showed that although pediatricians did not differ in their frequencies of communications, parents of CSHCN contributed more medical-related information and had higher rates of social exchanges and questions than parents of healthy children. CSHCN also participated more than healthy children. Children's health status did not influence pediatrician or parent satisfaction ratings of the visit. Pediatricians' satisfaction ratings were higher in medically oriented encounters, whereas parents' satisfaction ratings were not related to communication patterns. The results of this study underscore the role of parents of CSHCN in communicating medical information, as well as the importance of pediatrician-family relationships to families of CSHCN.