Evaluating provider communication in pediatric chronic kidney disease care using a global coding system. Issue 7 (July 2020)

• Record Type: Journal Article
• Authors: Coburn, Shayna S.; Callon, Wynne A.; Eakin, Michelle N.; Pruette, Cozumel S.; Brady, Tammy M.; Mendley, Susan R.; Tuchman, Shamir; Fivush, Barbara A.; Riekert, Kristin A.
• Is Part Of: Patient education and counseling. Volume 103:Issue 7(2020)
• Page Start: 1358
• Page End: 1365
• Publication Date: 2020-07
• Subjects: AYAs adolescents and young adults -- CKD chronic kidney disease -- CHAT: CKD hypertension adherence in teens -- GCRS Global Consultation Rating Scale; Pediatric -- Child -- Adolescent -- Young adult -- Patient-centered -- Patient-provider -- Coding -- Provider communication -- Chronic kidney disease -- Chronic illness -- Adherence -- Compliance; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2020.02.014
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: Patient-centered communication is emphasized in medical training and care models. Adolescents and young adults (AYAs) are in a developmentally sensitive period. We evaluated provider communication with AYAs with chronic kidney disease. Ratings were highest for initiating, gathering information, and developing rapport. Ratings were lowest for several patient-centered communication skills. Abstract: Objective: Among adolescents and young adults (AYAs) with chronic illness, effective provider communication is essential for patient-centered care during a sensitive developmental period. However, communication in chronic illness care for AYAs is not well studied. Our objectives were to describe the provider communication skills in pediatric chronic kidney disease (CKD) care visits; and determine if communication skills differ by AYA characteristics. Methods: We adapted a global consultation rating system for pediatric subspecialty care using audiotaped clinic encounters of 18 pediatric nephrologists with 99 AYAs (age M (SD) = 14.9(2.6)) with CKD stages 1–5 and 96 caregivers. We hypothesized that provider communication skills would differ by AYA characteristics (age, gender, and race). Results: The strongest provider skills included initiating the session and developing rapport; lowest rated skills were asking patient's perspective and checking understanding. Communication scores did not consistently differ by AYA age or race, but were rated higher with female AYAs in several domains (ps<0.05). Conclusions: Pediatric providers generally had adequate or good communication scores with AYAs, but improvement in certain skills, particularly with male AYAs, may further support patient-centered care. Practice implications: To achieve consistent, patient-centered communication with AYAs, an observation-based global assessment may identify areas for provider improvement.