Unraveling triadic communication in hospital consultations with adolescents with chronic conditions: the added value of mixed methods research

Patient Educ Couns. 2011 Mar;82(3):455-64. doi: 10.1016/j.pec.2010.12.001. Epub 2010 Dec 30.


Objective: To integrate findings of a mixed methods research (MMR) into adolescents' preferences and competencies for communication during consultations, in order to demonstrate the added value of MMR for health communication research.

Methods: Sequential MMR with adolescents (12-19 years) with various chronic conditions in a university hospital. Methods comprised: (1) 31 face-to-face interviews; (2) Q-methodology; (3) 39 observations of outpatient consultations; (4) three focus groups with 27 healthcare providers; (5) web-based questionnaire in 960 adolescents.

Results: Adolescents had different preferences regarding health communication, but all wished to be involved as partners. Yet, their actual participation during consultations was low. They often acted as bystanders rather than main characters because their participation was neither requested nor encouraged. Parents filled the gap, to healthcare providers' frustration. The questionnaire confirmed the discrepancy between self-efficacy and self-reported independent behavior during consultations.

Conclusion: Triadic communication was all but multi-party-talk and adolescents did not act and were not considered as main partners. MMR was of pivotal importance for our understanding.

Practice implications: As chronically ill adolescents need to prepare themselves for transition to adult care, healthcare providers should encourage them to take the lead in communication by initiating independent visits and changing the parents' roles.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Chronic Disease
  • Communication*
  • Focus Groups
  • Health Communication
  • Health Services Research / methods*
  • Health Services Research / standards*
  • Humans
  • Interviews as Topic
  • Parents
  • Patient Participation
  • Patient Satisfaction
  • Physician-Patient Relations*
  • Referral and Consultation
  • Research Design
  • Surveys and Questionnaires
  • Young Adult