Increasing patient knowledge, satisfaction, and involvement: randomized trial of a communication intervention
Abstract
A brief educational intervention to promote effective communication between physicians, children, and parents during pediatric office visits was designed and tested. A randomized clinical trial involving 141 children (5- to 15-year-olds) tested the effectiveness of the intervention to improve the process and outcome of medical care. The intervention was contained in three brief videotapes (one each for parents, physicians, and patients) and in accompanying written materials. Materials were designed to build skills and motivation for increased child competence and participation during pediatric medical visits. Control subjects saw health education videotapes and received materials comparable in length with those of experimental subjects. Postintervention medical visit process was analyzed using videotapes of visits. Visit outcomes, assessed with standardized instruments and interviews, included children's rapport with physicians, children's anxiety, children's preference for an active health role, children's recall of information, parents' satisfaction with the medical visit, and physician satisfaction. Results indicated that physicians in the intervention group, compared with their counterparts in the control group, more often included children in discussions of medical recommendations (50% vs 29%, t = 2.39, P less than .05); that children in the intervention group, compared with control children, recalled more medication recommendations (77% vs 47%, P less than .01) and reported greater satisfaction and preference for an active health role; and that the intervention and control groups did not differ in parent satisfaction, physician satisfaction, or child anxiety. The results suggest that a brief educational intervention administered during waiting room time can positively impact physician-child rapport and children's preference for an active role in health and their acquisition of medical information.
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Potential for unit of analysis error (patient clusters) in Lewis 1991 was addressed using mixed-effects analysis of variance with parent gender and experimental status as fixed effects and physician as a random effect.
“data were analysed using mixed‐effects analysis of variance (BMDP 3V microcomputer statistical program). Parent gender and experimental status were include as fixed effects, and physician was included as a random effect.”
From Interventions for providers to promote a patient-centred approach in clinical consultations (2012) · cites this paper as Lewis 1991
Blinding was at low risk in Lewis 1991 because videotapes were coded by a research assistant blind to the study hypotheses and design.
“Videotapes were coded by a research assistant blind to the study hypotheses and design”
From Interventions for providers to promote a patient-centred approach in clinical consultations (2012) · cites this paper as Lewis 1991
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“Good communication and encouraging children’s participation are key for both medical outcomes and the child’s well-being (De Winter et al., 2002; Lewis et al., 1991; Nova et al., 2005).”
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- Authors
- Lewis, C. C., Pantell, R. H., & Sharp, L.
- Affiliations
- University of California, San Francisco (US)
- Venue
- PEDIATRICS
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 1991-08-01
- Volume
- 88
- Issue
- 2
- Pages
- 351-358
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W1876224639
- Cited by
- 176
- References
- 0
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 5 · 2019: 2 · 2018: 5 · 2017: 5 · 2016: 7 · 2015: 5 · 2014: 3 · 2013: 3 · 2012: 7
- FWCI
- 3.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality (5 R01 HS 05408-03)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Ethics and Legal Issues in Pediatric Healthcare
- Keywords
- physician-patient communication, pediatric office visits, patient education intervention, childhood anxiety, drug recall, patient satisfaction, parental satisfaction, physician satisfaction
- MeSH terms
- Adult, Child, Psychology, Child, Communication, Female, Humans, Male, Office Visits, Parents, Patient Participation, Pediatrics, Physician-Patient Relations, Mental Recall
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