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Arch Pediatr Adolesc Med. 2012 Jan;166(1):62-7. doi: 10.1001/archpediatrics.2011.696.

Child health providers' precautionary discussion of emotions during communication about results of newborn genetic screening.

Author information

  • 1Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, WI 53226-0509, USA. mfarrell@mcw.edu

Abstract

OBJECTIVE:

To demonstrate a quantitative abstraction method for Communication Quality Assurance projects to assess physicians' communication about hidden emotions after newborn genetic screening.

DESIGN:

Communication quality indicator analysis.

SETTING:

Standardized parent encounters performed in practicing physicians' clinics or during educational workshops for residents.

PARTICIPANTS:

Fifty-nine pediatrics residents, 53 pediatricians, and 31 family physicians.

INTERVENTION:

Participants were asked to counsel standardized parents about a screening result; counseling was recorded, transcribed, and parsed into statements (each with 1 subject and 1 predicate). Pairs of abstractors independently compared statements with a data dictionary containing explicit-criteria definitions.

OUTCOME MEASURES:

Four groups of "precautionary empathy" behaviors (assessment of emotion, anticipation/validation of emotion, instruction about emotion, and caution about future emotion), with definitions developed for both "definite" and "partial" instances.

RESULTS:

Only 38 of 143 transcripts (26.6%) met definite criteria for at least 1 of the precautionary empathy behaviors. When partial criteria were counted, this number increased to 80 of 143 transcripts (55.9%). The most common type of precautionary empathy was the "instruction about emotion" behavior (eg, "don't be worried"), which may sometimes be leading or premature.

CONCLUSIONS:

Precautionary empathy behaviors were rare in this analysis. Further study is needed, but this study should raise concerns about the quality of communication services after newborn screening.

[PubMed - indexed for MEDLINE]
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