Gender differences in physician-patient communication. Evidence from pediatric visits.

OBJECTIVE: To determine whether physician gender and patient gender influence the process of communication and parent and child satisfaction during pediatric office visits. DESIGN: Content analysis of videotaped pediatric office visits. SETTING: University-based pediatric primary care practice. SUBJECTS: Videotaped communication between 212 children, ages 4 to 14 years, parents, and physicians. Thirty-eight percent were child health supervision visits, and 62% were for the management of minor or chronic illnesses. MAIN OUTCOME MEASURES: An established coding system of physician-patient communication and measures of parent and child satisfaction with medical care. RESULTS: Female physician visits were 29% longer than those of male physicians (P < .001). Compared with male physicians, female physicians engaged in more social exchange (P < .01), more encouragement and reassurance (P < .01), more communication during the physical examination (P < .05), and more information gathering (P < .01) with children. Male and female physicians engaged in similar amounts of discussions regarding illness management. Children were more satisfied with physicians of the same gender (P < .05), while parents were more satisfied with female physicians (P < .05). CONCLUSIONS: Children communicate more with female than with male physicians and show preferences for physicians of the same gender. These findings are consistent with communication patterns in adult patients and may have a significant influence on gender disparities in health care. Efforts at improving the process and outcome of medical care should address gender differences.

The relations of emotionality and regulation to children's anger-related reactions.

The purpose of this study was to examine the relations of emotionality (intensity and negative emotion) and regulation (attentional control, mode of coping) to preschoolers' naturally occurring anger reactions. School personnel's ratings of 4-6-year-olds' constructive coping and attentional control were associated with boys' constructive anger reactions whereas their ratings of acting out versus avoidant coping, emotional intensity, and anger intensity generally were correlated with low levels of constructive reactions to anger. Mothers' reports of children's constructive coping and low emotional intensity were associated with children's use of nonabusive language to deal with anger, whereas aggressive coping and negative emotionality were associated with escape behavior when angered. The findings are consistent with the conclusion that individual differences in emotionality and regulatory skills are associated with children's constructive versus nonconstructive anger reactions.

The relations of emotionality and regulation to preschoolers' social skills and sociometric status.

The purpose of this study was to examine the relations of emotionality (intensity and negative emotion) and regulation (coping and attentional regulation) to preschoolers' social skills (as rated by adults) and sociometric status. Teachers' ratings of children's constructive coping and attentional control were positively related to boys' social skills and peer status, whereas negative affect was negatively related. Acting out (vs. avoidant) coping and emotional intensity were negatively related to girls' and boys' social skills and boys' peer status. In addition, mothers' reports of boys' coping by seeking social support and low emotional intensity were associated with boys' positive social functioning, whereas avoidant coping was positively related to girls' rated social skills. The results are discussed in relation to research on emotion regulation and coping with emotion in interpersonal contexts.

Children's coping in self- and other-relevant contexts.

The purpose of this study was to examine children's coping strategies in situations in which negative events befall the children themselves and contexts in which children observe others in negative situations. Kindergarten and second-grade children and their mothers were interviewed about the children's coping strategies in distressing self- or other-relevant contexts (e.g., when the children themselves were socially rejected or when they observed a peer being rejected). According to both child and maternal reports, children were particularly likely to use instrumental coping strategies when they observed another child's distress; they appeared to prefer distracting and avoidant actions, crying, or support from others when they themselves experienced distress. With age, there also was evidence of a decrease in the use of support-related strategies, and increases in cognitive restructuring, cognitive avoidance, and direct problem-solving. Several sex differences consistent with gender stereotypes also were noted.

Is anybody talking to physicians about acquired immunodeficiency syndrome and sex? A national survey of patients.

OBJECTIVE: We wanted to know what proportion of the US population had spoken with a physician about sex and the acquired immunodeficiency syndrome (AIDS). In particular, we wanted to know whether patients who were at risk for sexually transmitted diseases, including human immunodeficiency virus (HIV), had had such discussions. DESIGN: A telephone survey of a US nationwide random probability sample of adults was conducted in the summer of 1991. PATIENTS: The survey was completed by 1350 adults; of these, 1312 were patients, defined as those who reported that they had been to a physician within the last 5 years. MAIN OUTCOME MEASURE: We assessed whether patients reported having had discussions about sex and AIDS with physicians. RESULTS: Only 259 (20%) of patients in our survey reported that they had talked with a physician about AIDS. Fifty-five (21%) of those who had talked with a physician about AIDS reported that the physician started the discussion. Few patients reported that they had spoken with a physician even when it appeared vital that they do so: 46 (26%) of those who reported that their chances of getting the AIDS virus were "high" or "medium" and 25 (23%) of those who reported being at behavioral risk for AIDS had spoken to a physician about AIDS. CONCLUSIONS: Few patients reported having discussed sex and AIDS with a physician, even if the patients considered themselves to be at risk for contracting HIV or another sexually transmitted disease. More of these discussions must take place to prevent the spread of sexually transmitted diseases and AIDS and to facilitate testing and early treatment of HIV-infected individuals.

How dentists see themselves, their profession, the public.

The public traditionally has held dentistry in high regard as a profession. But some recent evidence suggests a decline in public confidence--a fact that may be affecting the way dentists view themselves. What should and can be done?

Risks of the "big three": what dentists and patients believe about dental amalgam, fluoride and HIV.

Dental professionals have seriously considered the risks to the public from dental amalgam, fluoridated water and HIV transmission in the dental office. These issues are important to the public, who typically rely on practicing dentists for information about just how serious the risks are.