Communicating psychosocial problems in German well-child visits. What facilitates, what impedes pediatric exploration? A qualitative study

Abstract

Objective: To examine whether, and if so, how psychosocial topics are discussed between parents and pediatricians.

Methods: Thirty well-child visits at eight pediatricians' practices in southwest Germany were video recorded. Conversations were analyzed.

Results: Although psychosocial topics were frequently touched upon, they were rarely thoroughly explored. Pediatricians pursued a rather reserved conversation style. Especially when parents withdraw and psychosocial stressors are less baby-related, pediatricians hardly explore the psychosocial situation.

Conclusion: In summary, the pediatrician's conversation style, the nature of the stressors and the parents' openness are paramount in determining the depth of psychosocial exploration.

Practice implications: In order to ensure a good and fair quality of care to all parents, pediatricians should be provided with tailored communicative skills training allowing them to create a climate in which parents may open up and build trust toward their pediatrician.

Keywords: Conversation analysis; Early prevention; Parents; Parent–pediatrician communication; Pediatric well-child visits; Psychosocial stress.