Parent's participation and perspectives regarding clinical judgment and clinical guideline development

Current Opinion in Pediatrics

Volumn 10, Issue 5, 1998, Pages 476-479

  Pachter, Lee M ^a  

^a SAINT FRANCIS HOSPITAL AND MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CHILD HEALTH CARE; CLINICAL OBSERVATION; COMPREHENSION; DECISION MAKING; EXPECTATION; HEALTH CARE SYSTEM; HUMAN; PARENTAL BEHAVIOR; PRIORITY JOURNAL; SHORT SURVEY;

CHILD; DECISION MAKING; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HUMANS; PARENTS; PATIENT PARTICIPATION; PRACTICE GUIDELINES; PROFESSIONAL-FAMILY RELATIONS;

EID: 0031698125     PISSN: 10408703     EISSN: None     Source Type: Journal    
DOI: 10.1097/00008480-199810000-00004     Document Type: Short Survey

References (12)

1. Green M: Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. Arlington, VA: National Center for Education in Maternal and Child Health, 1994.
2. Young KT, Davis K, Schoen C, Parker S: Listening to parents: A national • survey of parents with young children. Arch Pediatr Adolesc Med 154:225-262, 1998. This study of a large sample of parents interviewed over the phone suggests that parents seek direction and advise from child health professionals about many issues that extend beyond the physical health needs of children. Parents seek advice on "new morbidity" issues such as psychosocial and behavior concerns, as well as parenting, child-rearing, and developmental information. Families who receive special pediatric services such as home visits, telephone advice lines, written educational information, and parent-held records rate higher levels of satisfaction with care.
3. Kai J: What worries parents when their preschool children are acutely ill, •• and why: A qualitative study. Br Med J 313:983-986, 1996. This series of papers from the British Medical Journal shows how well-designed qualitative research can offer crucial information about health care concerns from the parent's perspective. No questionnaire or survey could have results in the richness of descriptive information that is reported here. Of note, parents' decision making during acute childhood illness episodes is in part related to the parent's sense of control over the situation and concerns about the perceived threat of the illness episode-factors that readily fit into the Health Belief Model of health behavior. The decisions that are made by parents are related to internally logical and consistent belief systems, some of which may be biomedically incorrect but none-the-less logical. The gap can be bridged through communication between clinician and client.
4. Kai J: Parents' difficulties and informational needs in coping with acute •• illness in preschool children: A qualitative study. Br Med J 313:987-990, 1996. This series of papers from the British Medical Journal shows how well-designed qualitative research can offer crucial information about health care concerns from the parent's perspective. No questionnaire or survey could have results in the richness of descriptive information that is reported here. Of note, parents' decision making during acute childhood illness episodes is in part related to the parent's sense of control over the situation and concerns about the perceived threat of the illness episode-factors that readily fit into the Health Belief Model of health behavior. The decisions that are made by parents are related to internally logical and consistent belief systems, some of which may be biomedically incorrect but none-the-less logical. The gap can be bridged through communication between clinician and client.
5. Becker MH: The health belief model and personal health behavior. Health Educ Monogr 1974, 2:324-508.
6. Kleinman A, Eisenberg L, Good B: Culture, illness and care: Clinical lessons from anthropological and cross-cultural research. Ann Intern Med 88:251-258, 1978.
7. Britten N, Ukoumunne O: The influence of patients' hopes of receiving a • prescription on the doctors' perceptions and the decision to prescribe: A questionnaire survey. Br Med J 315:1506-1510, 1997. A British study of 544 patients and their general practitioners, reporting on patients' expectations of receiving a prescription and physicians' perceptions of the patients' expectation. Over 25% of patients who hoped for a prescription did not receive one. Doctors' perceptions of whether the patient wanted a prescription was the strongest determinant of the decision to prescribe, but that perception on the doctors' part was often incorrect; that is, some patients who the doctor felt expected or hoped for a prescription actually did not. More evidence for the need for increased discussion between physicians and patients.
8. Thorns ML, Bodnar PZ, O'Donovan C, Gouel EG, et al.: Parental knowl••edge and choice regarding live and inactivated poliovirus vaccines. Arch Pediatr Adolesc Med 151:809-812, 1997. Two hundred forty parents of children aged 2 weeks to 18 months who were being seen at their physician's office were given information on paralytic poliomyelitis as well as the advantages and disadvantages of both the oral polio vaccine (OPV) and the inactivated injectible vaccine (IPV). After getting this information, parents were asked to select a vaccine schedule (OPV only vs IPV only). Most parents stated that they would consult a physician prior to deciding, but of those who would make the decision without consulting anyone, 61% would have chosen the IPV schedule. This was preferred because it decreased the risk of vaccine-associated paralytic poliomyelitis. This was chosen despite the need for more injections. As Catherine D. DeAngelis, editor of the journal, commented: "Parents can almost always be counted on to do the right thing for their children."
9. Bauchner H, Adams W, Barnett E, Klein J: Therapy for acute otitis media: Preference of parents for oral or parenteral antibiotic. Arch Pediatr Adolesc Med 150:396-399, 1996.
10. Kramer MS, Etezadi-Amoli J, Ciampi A, Tange SM, et al.: Parents' versus physicians' values for clinical outcomes in young febrile children. Pediatrics 93:697-702, 1994.
11. Kramer MS, MacLellan AM, Ciampi A, Etezadi-Amoli J, Leduc DG: Parents' vs physicians' utilities (values) for clinical outcomes in potentially bacteremic children. J Clin Epidemiol 43:1319-1325, 1990.
12. McCarthy PL, Sznajderman SD, Lustman-Finding K, Baron MA, et al.: Mothers' clinical judgment: A randomized trial of the acute illness observation scales. J Pediatr 116:200-206, 1990.