Pediatric Clinicians' Support for Parents Makes a Difference: An Outcome-Based Analysis of Clinician-Parent Interaction

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Abstract
Pediatric clinicians frequently must offer support (e.g., reassurance) to anxious, stressed parents. Supportive clinician behaviors were studied to determine their impact on parents. Forty initial health supervision visits to a pediatric clinic were videotaped through a oneway mirror. Mothers were interviewed immediately before and 1 wk after the visits to ascertain changes in concerns, opinions of clinicians, perceptions of infants, and self-confidence. Mothers also completed a postvisit satisfaction questionnaire. Codes blinded to these outcomes identified and enumerated 3 supportive clinician behaviors: encouragement, reassurance, and empathy. Analyses compared visit outcomes according to high and low levels of maternal exposure to clinician support. Mothers exposed to high levels of encouragement had significant improvement in their opinions of clinicians and higher satisfaction (P = 0.02). Mothers exposed to high levels of empathy and had higher satisfaction and greater reduction in concerns (P < 0.05). No significant differences in outcome were found for exposure to reassurance. Differences in visit outcomes were not related to either maternal demographic factors or cliniciam type (pediatricians vs. pediatric nurse practitioners). Results suggest that pediatric clinicians'' support for parents makes a difference. Additional outcome-based analyses are needed to identify the full range of effective pediatric communication.

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