Objective: To examine informational and emotional patient-provider and patient-patient communication sequences (i.e. cues and subsequent responses) during Shared Medical Appointments (SMAs) for children and adolescents with type 1 Diabetes Mellitus (T1DM) and their parents.
Methods: 57 children/adolescents with T1DM and 36 healthcare providers participated in ten SMAs in seven Dutch hospitals. Parents were present in six SMAs. Video-recordings were made. Communication sequences, including informational and emotional cues and responses were rated using an adaptation of the Medical Interview Aural Rating Scale.
Results: 143 patient-initiated cues were identified, followed by 140 provider responses and 30 patient responses. Patients gave more informational than emotional cues. Informational cues were mostly medical-related. Subsequent responses provided by providers and patients contained mostly appropriate information. We identified 17 patient and four parent cues with multiple responses.
Conclusions: Almost all cues were identified by healthcare providers and responded to in an appropriate manner. Cues not followed by a provider's response were picked up by other patients. Providers acted as mediator between a patient cue and another patient's response, thereby stimulating the interaction during SMAs.
Practice implications: Professionals could more explicitly invite all participants to interact with each other, and enable them to have their share in the communication process.
Keywords: Communication; Diabetes type 1; Pediatrics; Sequence analysis; Shared Medical Appointment.
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