"They just say everything's a virus"--parent's judgment of the credibility of clinician communication in primary care consultations for respiratory tract infections in children: a qualitative study

Abstract

Objective: To investigate parents' experiences and views of clinician communication during primary care consultations for respiratory tract infections (RTIs) in children under 12.

Methods: Semi-structured interviews with 30 parents who had recently consulted for RTI in their child. Purposive sampling was used to interview parents from a range of socio-economic areas.

Results: Parents critically assess the credibility of primary care clinician diagnosis and treatment recommendations based on their perception of the medical evaluation and how well their concerns and expectations have been addressed. A "viral" diagnosis could be perceived as trivializing, particularly when contradicting the parent's perception of severity. Parents expected advice on symptomatic treatment and felt frustrated by 'no treatment' recommendations. Parents commonly reported safety netting advice which was too vague to be useful.

Conclusion: Parents' perception of the credibility of the diagnosis and treatment recommendations is influenced both by their expectations and the effectiveness of clinician communication. Opportunities are being missed to inform parents about symptomatic care and when to consult for children with RTIs.

Practice implications: Clinicians should tailor diagnostic explanations to parental expectations and concerns and address the symptoms of significance to parents. Clinicians should provide advice about symptom relief and more precise safety netting advice.

Keywords: Antibiotic; Child health; Communication; Parent; Patient satisfaction; Primary care; Respiratory tract infections; Safety-netting.