Let the Kid Speak: Dynamics of Triadic Medical Interactions Involving Pediatric Patients.

Communication in healthcare represents the complex interplay between multiple individual and contextual factors unfolding over the course of the medical encounter. Despite significant improvements in patient-centered care delivery, studies of health communication typically focus exclusively on clinical interactions between adult patients and their clinicians. Much less is known about non-dyadic interactions, such as pediatric triads involving a child patient and accompanying parent. Understanding the dynamics of triadic pediatric healthcare communication is the first step toward evaluating and ultimately optimizing these healthcare interactions. Thus, we undertook a mixed-method analysis of 28 audio-recorded triadic medical interactions between healthcare providers, pediatric asthma and allergy patients, and their parents to explore the prevalence of various features of these interactions. Our findings point to mechanisms through which healthcare providers and parents may facilitate or hinder children's involvement in their own asthma and allergy care, including interruptions, unclarified technical medical language, the flow of information exchange, and the formation of dyadic conversational partnerships (coalitions) between providers and parents. Our analyses further reveal that children's participation during their medical visits was minimal (13% of the interaction). Providers in our sample elicited input directly from pediatric patients more often than from parents, though the difference was small. Taken together, these findings provide a foundation on which to develop training and communication interventions to ensure that children have a voice in their medical care.

Correlates of Physicians' and Patients' Language Use during Surgical Consultations.

A multi-method approach was used to explore correlates of technical and complex language use within 145 audio-recorded physician-patient interactions. When discussing the prospect of surgery, physicians used more technical and complex language (more jargon, larger words, longer sentences) than patients on average. Patients' demographic characteristics (education, health literacy, English fluency) and markers of health (condition severity) inconsistently predicted physicians' and patients' use of complex and technical language. Interactions with happier and more hopeful patients involved less technical and complex language, but physicians' language use was unrelated to patients' emotions following the consultation. Finally, physicians' use of more technical language predicted greater patient satisfaction following the consultation, and physicians' use of more complex language at the initial consultation predicted better adherence by patients following surgery. Our results highlight the nuanced role of language use within healthcare interactions and identifies language complexity as a novel target for health communication research.