Specialists understanding of the health care preferences of chronically ill adolescents.
OBJECTIVE
Doctors must understand patients' priorities to create an effective treatment partnership. Little is known about whether subspecialist pediatricians understand chronically ill adolescents' preferences.


METHODS
A survey was conducted of 155 adolescents with chronic illnesses and 52 subspecialty physicians recruited from the same clinics of a children's hospital. Adolescents and physicians rated the importance that adolescents place on items relating to quality of care and physician-patient communication styles using a previously validated measure.


RESULTS
For quality of care items, rank order correlation between physicians and patient responses was high (r = .63, p < .001) and both rated pain management items as most important. Physicians underestimated the importance adolescents placed on communicating with the physician as a friend and medical-technical aspects of care. For communication items, physicians' responses were significantly different than adolescents for 13 of 17 items. Except for three items pertaining to autonomy, physician and patient responses were in the same direction, but adolescent responses were less extreme.


CONCLUSIONS
Physicians understood the importance of pain management to adolescents with chronic illnesses, but overestimated their desired level of autonomy. Asking adolescents for their preferences may be the first step in improving adolescents' experience of care.
Britto
Maria T
MT
Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA. maria.britto@cchmc.org
Slap
Gail B
GB
DeVellis
Robert F
RF
Hornung
Richard W
RW
Atherton
Harry D
HD
Knopf
Jennifer M
JM
DeFriese
Gordon H
GH
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D016497:Adolescent Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications; D001171:Arthritis, Juvenile / Q000150:complications; D002648:Child; D002908:Chronic Disease; D003550:Cystic Fibrosis / Q000150:complications; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications; D008297:Male; D010146:Pain / Q000209:etiology / Q000523:psychology; D059408:Pain Management; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011159:Population Surveillance; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires