title: "They just say everything's a virus"--parent's judgment of the credibility of clinician communication in primary care consultations for respiratory tract infections in children: a qualitative study.
abstract: OBJECTIVE
  To investigate parents' experiences and views of clinician communication during primary care consultations for respiratory tract infections (RTIs) in children under 12.
  
  
  METHODS
  Semi-structured interviews with 30 parents who had recently consulted for RTI in their child. Purposive sampling was used to interview parents from a range of socio-economic areas.
  
  
  RESULTS
  Parents critically assess the credibility of primary care clinician diagnosis and treatment recommendations based on their perception of the medical evaluation and how well their concerns and expectations have been addressed. A "viral" diagnosis could be perceived as trivializing, particularly when contradicting the parent's perception of severity. Parents expected advice on symptomatic treatment and felt frustrated by 'no treatment' recommendations. Parents commonly reported safety netting advice which was too vague to be useful.
  
  
  CONCLUSIONS
  Parents' perception of the credibility of the diagnosis and treatment recommendations is influenced both by their expectations and the effectiveness of clinician communication. Opportunities are being missed to inform parents about symptomatic care and when to consult for children with RTIs.
  
  
  CONCLUSIONS
  Clinicians should tailor diagnostic explanations to parental expectations and concerns and address the symptoms of significance to parents. Clinicians should provide advice about symptom relief and more precise safety netting advice.
authors.affiliation: Centre for Academic Primary Care, NIHR School of Primary Care Research, School of Social & Community Medicine, University of Bristol, Bristol, UK. Electronic address: Christie.cabral@bristol.ac.uk.
authors.forename: Christie
authors.initials: C
authors.lastname: Cabral
authors.affiliation: Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Ingram
authors.affiliation: Centre for Academic Primary Care, NIHR School of Primary Care Research, School of Social & Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Alastair D
authors.initials: AD
authors.lastname: Hay
authors.affiliation: Centre for Academic Primary Care, NIHR School of Primary Care Research, School of Social & Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Horwood
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003142:Communication; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D017060:Patient Satisfaction; D010465:Perception; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000379:methods*; D036301:Qualitative Research; D012017:Referral and Consultation; D012141:Respiratory Tract Infections / Q000628:therapy*
keywords: Antibiotic; Child health; Communication; Parent; Patient satisfaction; Primary care; Respiratory tract infections; Safety-netting