Abstract
BackgroundIn pediatrics, communication often occurs through an intermediary such as a caregiver. The goal of this study is to assess caregiver communication expectations and determine if meeting expectations influences caregiver satisfaction or instruction retention.MethodsA survey study was performed at the Children’s Hospital of Philadelphia. Before the visit, caregivers completed a survey on communication expectations, Caregiver Expected Kalamazoo Essential Elements Communication Checklist (Caregiver Expected KEECC). After the visit, caregivers were surveyed on their perception of physician communication (Caregiver Perceived KEECC) and satisfaction. Caregivers were contacted 1 week after the clinic visit to assess instruction retention. Meeting of caregiver expectation was calculated by the difference between Caregiver Expected and Caregiver Perceived KEECC scores.Results112 caregivers participated in the study. There was no significant difference in Caregiver Expected KEECC versus Caregiver Perceived KEECC score (4.39 vs 4.56). Caregiver communication expectations were exceeded in 51.5% of the visits. Communication expectations were exceeded more among caregivers with at a college education (p < 0.01) and more among White caregivers (p < 0.01). The average caregiver satisfaction score with the clinic visit was 4.67. Higher satisfaction scores were observed in caregivers who had their communication expectations met or exceeded (p < 0.01). Caregivers with communication expectations exceeded had higher percentage recall of physician instructions (p < 0.01).ConclusionsCaregiver communication expectations may be influenced by demographic factors. Communication expectation affects visit outcomes including caregiver satisfaction and instruction retention. Therefore, physicians need to be cognizant of caregiver communication expectations, which can impact quality of the healthcare experience.
Highlights
In pediatrics, communication often occurs through an intermediary such as a caregiver
Patient-physician communication often occurs through a third party instead of directly with the patient
Previous published studies on communication behavior have ranged in size from 20 up to 458 [8, 16, 22, 25, 26] to determine an estimated target sample size
Summary
Communication often occurs through an intermediary such as a caregiver. Effective communication allows for directed discussion of health issues to inform diagnoses and treatment plans, and establishes positive and healthy relationships with patients [1, 2]. Patient-physician communication often occurs through a third party (parent or caregiver) instead of directly with the patient. In this communication model, the caregiver serves as a patient advocate, and physicians rely on the caregivers to describe the patient’s problems. Patient behavior can influence the quality of communication as anxiety and fear may make patients feel less comfortable to share the information necessary for the physician to make a proper diagnosis [4]. Dedicated training in interview skills [6] and an awareness of patient communication behaviors and expectations can help physicians develop more effective communication skills
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