Journal
SOCIAL SCIENCE & MEDICINE
Volume 60, Issue 5, Pages 949-964Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.socscimed.2004.06.040
Keywords
conversation analysis; doctor-patient communication; antibiotic prescribing; pediatric care; USA
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This study draws on a database of 570 community-based acute pediatric encounters in the USA and uses conversation analysis as a methodology to identify two formats physicians use to recommend non-antibiotic treatment in acute pediatric care (using a subset of 309 cases): recommendations for particular treatment (e.g., I'm gonna give her some cough medicine.) and recommendations against particular treatment (e.g., She doesn't need any antibiotics.). The findings are that the presentation of a specific affirmative recommendation for treatment is less likely to engender parent resistance to a non-antibiotic treatment recommendation than a recommendation against particular treatment even if the physician later offers a recommendation for particular treatment. It is suggested that physicians who provide specific positive treatment recommendation followed by a negative recommendation are most likely to attain parent alignment and acceptance when recommending a non-antibiotic treatment for a viral upper respiratory illness. (C) 2004 Elsevier Ltd. All rights reserved.
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