Examining the interactions and behaviours in consultations for childhood respiratory tract infections

This study will look at communication and decision making in consultations for cough in children under 12 years old.  Cough is a very common reason for parents and children to consult the doctor, at a cost of £32 million a year to the  NHS. However, usually the cough is minor and self-limiting.

Parents do not want to consult unnecessarily but are often uncertain about when they should consult and anxious about the symptoms. There is clinical uncertainty about the management of some cases of acute cough and sometimes there is inappropriate prescribing of antibiotics. Misunderstandings are known to occur in these consultations and to contribute to both over prescription of antibiotics and high consulting rates.

This study will video consultations for cough in children under 12 years (an age range for which the parent still plays a key role in communication in the consultation). Parents will be asked to fill out a questionnaire on their demographic details and expectations before the consultation and a questionnaire about their satisfaction after the consultation. With consent in place, clinicians will video record the consultations. All the clinicians and some of the parents will take part in an indepth interview about the consultation. Parents will be selected for interview using their satisfaction scores and demographic details such that parents from a range of backgrounds and with a range of consultation experiences are interviewed. The videos will be used as a prompt to help participants remember what happened in the consultation and to explain the communication and decision making that took place.

This research aims to improve understanding of communication and decision making within these consultations, in order to inform interventions with potential benefits to the NHS of reducing antibiotics prescribing and the need for future consultations.

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