RT Journal
A1 Farrell MH, Speiser J, Deuster L, Christopher S
T1 CHild health providers' precautionary discussion of emotions during communication about results of newborn genetic screening
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2012
FD January 1
VO 166
IS 1
SP 62
OP 67
DO 10.1001/archpediatrics.2011.696
UL http://dx.doi.org/10.1001/archpediatrics.2011.696
AB Objective 
                  To demonstrate a quantitative abstraction method for Communication Quality Assurance projects to assess physicians' communication about hidden emotions after newborn genetic screening.Design 
                  Communication quality indicator analysis.Setting 
                  Standardized parent encounters performed in practicing physicians' clinics or during educational workshops for residents.Participants 
                  Fifty-nine pediatrics residents, 53 pediatricians, and 31 family physicians.Intervention 
                  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.Outcome Measures 
                  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.