Responsibility to report symptoms: Pursuing symptom reports from children in pediatric encounters

Abstract

ObjectiveThe paper focuses on cases in which children disconfirm a symptom previously reported by their parents and analyzes how doctors and parents continue asking questions to elicit symptom confirmation from children. MethodsThe study employs Conversation Analysis (CA) to examine 50 video recordings of Russian-language pediatric consultations with 4 pediatricians and approximately 50 children. ResultsThe findings indicate two strategies used by participants to pursue symptom confirmation. First, calibrating question design via changing the questions’ format and narrowing the questions’ topical agenda to specify what kind of information is expected from the child. Second, changing the questions’ format (from content to polar) without adjusting the topical agenda. ConclusionThe paper argues that engaging children in medical consultations might be challenging because they do not orient to, and so do not perform a responsibility that is institutionally expected from patients, in particular, reporting medically-relevant information.Practice implications:The analysis shows that using polar questions about everyday activities and experiences relevant to the child and pursuing symptom reports by gradually narrowing down the questions’ topical agenda can be an effective way to secure medically-relevant information.