Ostensible Versus Actual Reasons for Seeking Pediatric Attention: Another Look at the Parental Ticket of Admission

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Abstract
The presentation of parental anxiety that appears excessive in view of the nature of the child''s chief complaint is a frequent occurrence in pediatric practice. Sick-patient visits in 1 (370) pediatric office during 3-mo. period are reviewed. Additional questioning in the area of parental anxieties concerning these symptoms revealed that in 125 instances (33.8%), the parent was entertaining unverbalized fears that something much more serious was wrong with the child than could be anticipated from the ostensible reason for seeking assistance. An analysis of the actual reason for coming reveals that the child''s presenting complaint has become associated for the parent with the following: family history of serious life-threatening illness; fears of loss and separation; death; the fears of another family member who is pressing for answers about the problem; fears of loss of vital functions; and a variety of other thought processes that have somehow become linked to the child''s symptom. Techniques for recognizing and ameliorating this parenting difficulty are discussed.

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