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Children in chronic pain: Promoting pediatric patients' symptom accounts in tertiary care

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  • Clemente, Ignasi
  • Lee, Seung-Hee
  • Heritage, John

Abstract

This paper examines how clinicians promote pediatric patients' symptom accounts at the beginning of visits in three pediatric tertiary care clinics at a university hospital in the United States: pain, gastroenterology and neurology. Quantitative and qualitative data were collected for 69 patient-parent pairs, including videotaped intake visits. Two forms of child account promotion, together with their corresponding distribution across clinics, were identified: (1) Epistemic prefaces were used to upgrade the patient's epistemic status and to establish the child as primary informant; and, (2) non-focused questioning was used to permit children latitude in the formulation of symptoms and experiences. In general, epistemic prefaces were characteristic of the gastroenterology and neurology visits, while non-focused questioning was found overwhelmingly in the pain encounters.

Suggested Citation

  • Clemente, Ignasi & Lee, Seung-Hee & Heritage, John, 2008. "Children in chronic pain: Promoting pediatric patients' symptom accounts in tertiary care," Social Science & Medicine, Elsevier, vol. 66(6), pages 1418-1428, March.
    • Handle: RePEc:eee:socmed:v:66:y:2008:i:6:p:1418-1428
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    References listed on IDEAS

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    1. Peters, Sarah & Stanley, Ian & Rose, Michael & Salmon, Peter, 0. "Patients with medically unexplained symptoms: Sources of patients' authority and implications for demands on medical care," Social Science & Medicine, Elsevier, vol. 46(4-5), pages 559-565, February.
    2. Ring, Adele & Dowrick, Christopher F. & Humphris, Gerry M. & Davies, John & Salmon, Peter, 2005. "The somatising effect of clinical consultation: What patients and doctors say and do not say when patients present medically unexplained physical symptoms," Social Science & Medicine, Elsevier, vol. 61(7), pages 1505-1515, October.
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