How much explanation is enough? A study of parent requests for informationand physician responses

Objective.-To examine the relationship between doctor-parent communication patterns and parents' perceptions that they were listened to by the doctor. Design.-Cross-sectional, clinic-based survey. Before the visit, parents wer e asked about the strength of their desires/preferences for being listened to; after the visit, they were asked if their desires were fulfilled and to rate their satisfaction with care. Encounters were audiotaped, transcribed , and coded for parent requests for information and action and physician re sponses to those requests. Coding was performed using an adapted version of the Taxonomy of Requests by Patients (TORP). Physician responses to parent al requests for information were coded as brief. moderate, or prolonged ful fillment or as partially fulfilled, ignored, or denied. Setting.-Two private pediatric practices, I community based and I universit y based. Participants.-Ten of 13 eligible physicians (participation rate. 77%) and 3 06 of 356 eligible parents (participation rate, 86%) who sought care for th eir children's respiratory illnesses. Parents were invited to participate i f they spoke and read English and if their child was 2-10 years old. had a chief complaint of cold symptoms. and was seeing one of the participating p hysicians. Complete data were obtained for 287 doctor-parent encounters (94 %). Results.-Before the visit. 74% of parents reported that they considered it necessary for the physician to listen to their ideas about their child's il lness. Among these parents. 62% (n = 130) reported after the visit that the physician had listened to their ideas. As the proportion of moderate-lengt h responses to parent requests for information increased, parents were sign ificantly more likely to report being listened to (P < .05). Multivariate r esults indicated a 59% probability of parents reporting that they were list ened to when given moderate-length responses, 45% when given brief response s, 39% when given prolonged responses, and 12% when requests for informatio n were only partially fulfilled., ignored, or denied. The length of respons e to parent requests for information was not related to overall parent sati sfaction. Conclusions.-Parents who received moderate-length answers to their question s were most likely to report that they were listened to. Although it is ass umed that lengthier, in-depth explanations result in higher satisfaction, t his study suggests that more doctor talk does not necessarily constitute be tter communication.