• Patricia Cahill and Alexia Papageorgiou.
• The Norwich Road Surgery, Ipswich, Suffolk. patriciacahill@doctors.org.uk
• Br J Gen Pract. 2007 Nov 1; 57 (544): 866871866-71.

BackgroundThere is a paucity of research evidence concerning communication in paediatric consultations between GPs, adults, and child patients.AimThis study was carried out to identify features of the interaction between a doctor, a child patient aged 6-12 years, and their carer in the consultation associated with the child's participation.Design Of StudyA qualitative analysis of video recordings of 31 primary care paediatric consultations was undertaken, using strategies from the methodology of conversation analysis.SettingPrimary care, Suffolk, UK.MethodNHS GPs from three primary care trusts (PCTs), were invited to participate in this study. Sixteen volunteers from this sample took part.ResultsAnalysis of the interaction in the consultations revealed that the children had little involvement. Children participated when invited to do so, and took more time than adults to answer a doctor's question. An adult carer was less likely to answer on behalf of a child, when they were in a position to see that the doctor's gaze was directed at the child, and the doctor addressed the child by name. Adult carers, who had not voiced their own concerns first, were seen to interrupt doctor-child talk. In consultations where the participants sat in a triangular arrangement, all parties being an equal distance apart, triadic talk was noted.ConclusionChild involvement in the primary care consultation is associated with adult carers being able to voice their own concerns early in the consultation, and children being invited to speak with the appropriate recipient design.

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