Child health providers' precautionary discussion of emotions during communication about results of newborn genetic screening.
OBJECTIVE
To demonstrate a quantitative abstraction method for Communication Quality Assurance projects to assess physicians' communication about hidden emotions after newborn genetic screening.


METHODS
Communication quality indicator analysis.


METHODS
Standardized parent encounters performed in practicing physicians' clinics or during educational workshops for residents.


METHODS
Fifty-nine pediatrics residents, 53 pediatricians, and 31 family physicians.


METHODS
Participants were asked to counsel standardized parents about a screening result; counseling was recorded, transcribed, and parsed into statements (each with 1 subject and 1 predicate). Pairs of abstractors independently compared statements with a data dictionary containing explicit-criteria definitions.


METHODS
Four groups of "precautionary empathy" behaviors (assessment of emotion, anticipation/validation of emotion, instruction about emotion, and caution about future emotion), with definitions developed for both "definite" and "partial" instances.


RESULTS
Only 38 of 143 transcripts (26.6%) met definite criteria for at least 1 of the precautionary empathy behaviors. When partial criteria were counted, this number increased to 80 of 143 transcripts (55.9%). The most common type of precautionary empathy was the "instruction about emotion" behavior (eg, "don't be worried"), which may sometimes be leading or premature.


CONCLUSIONS
Precautionary empathy behaviors were rare in this analysis. Further study is needed, but this study should raise concerns about the quality of communication services after newborn screening.
Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, WI 53226-0509, USA. mfarrell@mcw.edu
Michael H
MH
Farrell
Jodi
J
Speiser
Lindsay
L
Deuster
Stephanie
S
Christopher
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D003376:Counseling; D004644:Emotions; D004645:Empathy; D005260:Female; D005820:Genetic Testing; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015997:Neonatal Screening / Q000523:psychology*; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care