Arzt-Patient-Kommunikation in der Rehabilitation von Jugendlichen

Abstract

PURPOSE: The pursuit of autonomy during adolescence affects chronic disease management of teenagers. To date, little is known about how adolescents rate independent conversations with their rehabilitation physician, whether they classify these conversations as effective and which factors (age, anxiety, excitement) influence the feeling of assurance in communication with the doctor. MATERIALS AND METHODS: 179 chronically ill adolescents between 13.5 and 19 years, undergoing rehabilitation treatment, completed a self-reported-questionnaire and were asked whether one of their parents accompanies them when visiting a physician at home. For identification of self-rated communication effectiveness with the rehabilitation physician, the translated Conversational Effectiveness Scale was employed. Self-phrased items were used to assess anxiety/excitement when communicating with the rehabilitation physician. RESULTS: 13.5% had never spoken with a doctor alone and merely 23.2% always/almost always have private conversations with their doctor. While female adolescents were significantly more anxious than their male contemporaries, no relations were found between age, conversational effectiveness and fears. Correlations show that increased anxiety/excitement goes along with less conversational effectiveness (r=0.409). DISCUSSION: More effective physician-patient-communication is only possible, when fears are reduced sustainably in rehabilitation. Female adolescents form a special group, showing higher anxiety than males, independent of age. CONCLUSIONS: Physicians in rehabilitation practice have to be prepared for different fears of adolescents and need special communication skills, since increased age or previous experiences with self-contained physician-patient conversation do not go along with a reduction of anxiety.