Family-clinician interactions in children's health services: a secondary analysis of occupational therapists' practice descriptions.
BACKGROUND
Effective family-clinician interactions are important for good health outcomes. Two types of interactions are consistently recommended: relational (e.g. listening, empathy, and respect) and participatory (e.g. shared decision-making, planning and problem-solving), but there is little specific guidance on how to implement these interactions in practice.


OBJECTIVE
To identify specific, practice-based examples of relational and participatory family-clinician interactions in children's occupational therapy.


METHODS
A qualitative secondary analysis was used. The data consisted of a list of occupational therapists' self-reported practice actions (n = 217) and direct quotes describing their content and context. The practice actions were categorized into a range of relational and participatory family-centred interactions using a modified framework analysis.


RESULTS
Of the 217 practice actions, the majority [121 (55.76%)] did not describe examples of therapists implementing family-clinician interactions. Of the remaining practice actions, 19 (8.76%) described 'relational' interactions (e.g. 'Listen to carer', 'Gather perspectives from others'); 47 (21.66%) described 'participatory' interactions (e.g. 'Identify the family's goals and priorities', 'Allow the family to choose'); 2 (0.92%) described both ('Take guidance from carers'); and 28 (12.9%) were excluded from the analysis.


CONCLUSIONS
A range of relational and participatory interactions were identified. Descriptions of participatory interactions were more frequent than descriptions of relational interactions, and overall the therapists described their family-clinician interactions less frequently than their other practice actions. The specific, real-life examples of different types of interactions identified in the study can be used as a basis for reflection on practice and developing more specific guidance.
Children's Occupational Therapy Service, Leeds Community Healthcare NHS Trust, Leeds, UK.
Jennifer
J
McAnuff
Faculty of Health and Life Sciences, York St. John University, York, UK.
Chris
C
Boyes
Institute of Health and Society, Newcastle University, Newcastle, UK.
Niina
N
Kolehmainen
D001291:Attitude of Health Personnel; D002648:Child; D002662:Child Health Services; D003657:Decision Making; D006801:Humans; D009788:Occupational Therapy / Q000379:methods*; D011368:Professional-Family Relations; D036301:Qualitative Research; D011787:Quality of Health Care
family-centred service; occupational therapy; patient-clinician interactions; qualitative secondary analysis; quality of care