DOCTOR-CHILD COMMUNICATION: IMPROVING HEALTH OUTCOMES

医童沟通：改善健康状况

• 批准号: 3371377
• 负责人: ROBERT H PANTELL
• 金额: $ 13.26万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 1986
• 资助国家: 美国
• 起止时间: 1986-02-01 至 1989-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3371377
• 关键词: asthma; cognition; health behavior; health care cost /financing; health care quality; health care service utilization; health education; human subject; informatics; middle childhood (6-11); parent offspring interaction; patient care management; pediatrics; physicians; satisfaction

We propose to test a communication intervention designed to promote active, competent communication between physicians and children in an office setting. We hypothesize that the proposed intervention will increase children's participation in medical encounters and increase the extent and cognitive appropriateness of physicians' communication to children in substantive areas. Further, we hypothesize that the proposed intervention will increase children's knowledge and active participation in their health care, improve parents' utilization of medical services and improve physician satisfaction. In subsamples of asthmatic children we expect the intervention to improve children's management skills and reduce parents' utilization of medical services. Our educational intervention targets all three participants in the pediatric medical encounter: physician, child and parent. The intervention is contained in videotapes and written materials. The major components of our communication model are: (1) Physicians should increase their direct communication with children in substantive content areas; (2) Information should be provided to children at a cognitively appropriate level; (3) Children should actively participate in the medical interview and express their concerns; (4) Parents should be encouraged to express their concerns in the form of a clear agenda. One hundred and eighty patients ages 7-14, their accompanying parents, and 62 physicians will be studied. A subsample of 80 children will be chronic asthmatics. Half the physicians will be randomly assigned to an experimental group; half will be assigned to a control group. Assignment of patients and parents will be determined by the assignment of their physicians. Three types of outcomes will be studied: interview process; post-encounter outcomes for patient, parent and physician; and cost effectiveness of the intervention. Data will be analyzed using analysis of variance and multiple regression. The long term objectives of this project are: 1) to demonstrate the effectiveness of an exportable educational intervention in enhancing the process of the medical interview; and 2) to demonstrate the causal relationship between the communication process and medical outcomes including children's ability to manage their own health and illness and parents' effectiveness in utilizing medical care.

我们建议测试一种旨在促进积极、 在办公室里，医生和孩子之间的良好沟通 布景。我们假设拟议中的干预措施将增加 儿童参与医疗接触的程度和程度增加 医生对儿童沟通的认知适宜性研究 实质性领域。此外，我们假设拟议的干预措施 将增加儿童对健康的了解和积极参与 关爱，提高家长对医疗服务的利用，提高 医生的满意度。在哮喘儿童的亚样本中，我们预计 提高儿童管理技能和减少家长管理能力的干预 医疗服务利用情况。 我们的教育干预针对的是 儿科就诊：医生、儿童和父母。这个 干预包含在录像带和书面材料中。少校 我们沟通模式的组成部分是：(1)医生应该增加 在实质性内容领域与儿童进行直接交流；(2) 应在认知上适当的情况下向儿童提供信息 (3)儿童应积极参与医学访谈 并表达他们的关切；(4)应鼓励父母表达 他们的关切以明确议程的形式出现。 180名7-14岁的患者及其随行父母，以及 将对62名医生进行研究。一个由80名儿童组成的子样本将会是慢性的 哮喘患者。一半的医生将被随机分配到 试验组；一半将被分配给控制组。赋值 患者和父母的比例将由他们的分配决定 医生。三种类型的结果将被研究：面谈过程； 患者、家长和医生遭遇后的结果；以及成本 干预措施的有效性。 数据将使用方差分析和多元回归进行分析。 该项目的长期目标是：1)展示 可输出的教育干预措施在提高 医学面谈过程；2)证明因果关系 沟通过程与医疗结局的关系 包括儿童管理自己的健康和疾病的能力以及 父母在利用医疗保健方面的有效性。