title: Non-antibiotic treatment recommendations: delivery formats and implications for parent resistance.
abstract: 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 a 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.
authors.affiliation: Max Planck Institute for Psycholinguistics, Language and Cognition Group, PB 310, 6500 AH Nijmegen, The Netherlands. Tanya.Stivers@mpi.nl
authors.forename: Tanya
authors.initials: T
authors.lastname: Stivers
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D003142:Communication; D006801:Humans; D010290:Parents; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents