title: Communicating psychosocial problems in German well-child visits. What facilitates, what impedes pediatric exploration? A qualitative study.
abstract: OBJECTIVE
  To examine whether, and if so, how psychosocial topics are discussed between parents and pediatricians.
  
  
  METHODS
  Thirty well-child visits at eight pediatricians' practices in southwest Germany were video recorded. Conversations were analyzed.
  
  
  RESULTS
  Although psychosocial topics were frequently touched upon, they were rarely thoroughly explored. Pediatricians pursued a rather reserved conversation style. Especially when parents withdraw and psychosocial stressors are less baby-related, pediatricians hardly explore the psychosocial situation.
  
  
  CONCLUSIONS
  In summary, the pediatrician's conversation style, the nature of the stressors and the parents' openness are paramount in determining the depth of psychosocial exploration.
  
  
  CONCLUSIONS
  In order to ensure a good and fair quality of care to all parents, pediatricians should be provided with tailored communicative skills training allowing them to create a climate in which parents may open up and build trust toward their pediatrician.
authors.affiliation: Center for Pediatrics and Adolescent Medicine of the University Medical Center Freiburg, Germany. Electronic address: lorena.krippeit@uniklinik-freiburg.de.
authors.forename: Lorena
authors.initials: L
authors.lastname: Krippeit
authors.affiliation: Center for Pediatrics and Adolescent Medicine of the University Medical Center Freiburg, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Belzer
authors.affiliation: Center for Pediatrics and Adolescent Medicine of the University Medical Center Freiburg, Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Martens-Le Bouar
authors.affiliation: TUM Technical University Munich, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Mall
authors.affiliation: Center for Pediatrics and Adolescent Medicine of the University Medical Center Freiburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Barth
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis*; D002669:Child Welfare / Q000523:psychology; D003142:Communication; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D010290:Parents / Q000523:psychology*; D010817:Physician-Patient Relations; D002666:Psychology, Child; D036301:Qualitative Research; D013315:Stress, Psychological; D014743:Videotape Recording
keywords: Conversation analysis; Early prevention; Parents; Parent–pediatrician communication; Pediatric well-child visits; Psychosocial stress