Children in chronic pain: Promoting pediatric patients' symptom accounts in tertiary care

Ignasi Clemente, Seung-Hee Lee and John Heritage

Social Science & Medicine, 2008, vol. 66, issue 6, 1418-1428

Abstract: This paper examines how clinicians promote pediatric patients' symptom accounts at the beginning of visits in three pediatric tertiary care clinics at a university hospital in the United States: pain, gastroenterology and neurology. Quantitative and qualitative data were collected for 69 patient-parent pairs, including videotaped intake visits. Two forms of child account promotion, together with their corresponding distribution across clinics, were identified: (1) Epistemic prefaces were used to upgrade the patient's epistemic status and to establish the child as primary informant; and, (2) non-focused questioning was used to permit children latitude in the formulation of symptoms and experiences. In general, epistemic prefaces were characteristic of the gastroenterology and neurology visits, while non-focused questioning was found overwhelmingly in the pain encounters.

Keywords: USA; Children; Chronic; condition; Pain; Communication; Biopsychosocial; Patient; participation (search for similar items in EconPapers)
Date: 2008
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