Factors influencing parental participation in a paediatric cardiology outpatient clinic

Abstract

Twelve-hundred consultations at a paediatric cardiology outpatient clinic were observed and tape-recorded. A random sample of 102 consultations was selected and an analysis made of the demand for information by parents and the extent to which this was met. Statistically significant differences in numbers of questions asked were found related to stage of treatment, seriousness of condition and outcome of consultation. Most questions were asked either when definitive information was available (i.e. following cardiac catheterisation) or when active intervention was contemplated (i.e. catheterisation or surgery). Contrary to parent's accounts in subsequent home interviews, the number of questions they ask is unrelated to the length of the consultation. Similarly the presence of many medical staff at the consultation, was positively correlated with the number of parents' questions. In general there was a good fit between parental participation and those occasions where most was at stake except at the first outpatient appointment. This was regarded, at least in retrospect, as unsatisfactory by many parents irrespective of its length or content. We suggest that an additional but optional “pre-admission” outpatient appointment where the family visit the wards prior to the child's admission to hospital may help parents cope with their anxieties.