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Clinical Pediatrics
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Physician and Patient Characteristics Associated With Discussion of Psychosocial Health During Pediatric Primary Care Visits

Jonathan D. Brown, PhD, MHS

Mathematica Policy Research, Inc, Washington, District of Columbia, jbrown{at}mathematica-mpr.com

Lawrence S. Wissow, MD, MPH

Department of Health, Behavior, and Society

Anne W. Riley, PhD

Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

This study examined whether physical pain, mental health symptoms, and provider characteristics were associated with the discussion of children's behavior, mood, getting along with others, school performance, family stress, and parent stress during 800 pediatric primary care visits to 54 providers in 13 clinics. The discussion of psychosocial health was more common when the child demonstrated hyperactivity symptoms, the visit was for a mental health problem, and the provider was a woman or reported greater confidence in mental health treatment skills, but less common when the child demonstrated physical pain. Provider gender, psychosocial orientation, the reason for the visit, and the child's characteristics did not explain the inverse relationship between pain and discussion. This suggests that multilevel factors that describe the child and provider are associated with the discussion of psychosocial health, and that pain interferes with discussion during all types of visits and during visits with children who are impaired by mental health symptoms.

Key Words: communication • primary care • mental health • pediatric

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This version was published on December 1, 2007

Clinical Pediatrics, Vol. 46, No. 9, 812-820 (2007)
DOI: 10.1177/0009922807304144
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[Abstract] [Full Text] [PDF]

This Article
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