![]() They do, however, suggest that physicians should be capable of addressing all recommended guidance topics, even if they tailor what they cover to each family's particular needs. 4 It is doubtful that these organizations expect physicians to address all age-appropriate topics with every patient. The third edition of the American Academy of Pediatrics guidelines devotes several times more space to anticipatory guidance and covers many more topics than the second edition. Such lists have grown substantially longer in recent years. The American Academy of Pediatrics' Guidelines for Health Supervision 2 and the Maternal and Child Health Bureau's Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents 3 provide lists of age-related topics for clinicians to discuss with parents as part of well-child care. In contemporary times, providing preventive advice is called anticipatory guidance, and it is an integral part of well-child care. 1(p43)įor at least a century, physicians who take care of children have been answering parents' questions about basic aspects of child rearing. The doctor is taking the place more and more of the `advice-offering neighbor,' and it behooves him to be able to advise the mother correctly. If her confidence is to be retained, the physician must be as familiar with the proper manner of bathing a baby as he is with the treatment of pneumonia, and he may render the baby as notable a service in one instance as in the other. Instead of asking mother or grandmother what should be done, the doctor is consulted. Our curriculum covers a certain amount of study of the anatomy and physiology of the child about which mothers never ask us, but the information which they seek has to do with that which cannot be obtained from books, but rather is that sort of knowledge which has passed from mouth to mouth down through the centuries. Effort is required to provide parents with the information they need to take good care of their children. Many parents could use more information on these topics. ![]() Parents who could use more information on a larger number of topics were much more willing to pay for additional care.Ĭonclusions Although anticipatory guidance is considered an important component of well-child care, the majority of parents reported that they had not discussed most standard topics with a clinician. Parents who had discussed more of these topics with a clinician were more likely to report excellent care. Among parents who had not discussed a particular issue, the percentage who reported that they could use more information ranged from 22% for both newborn care and crying to 55% for encouraging learning similar percentages who had discussed the topics could also use more information. Thirty-seven percent of parents had not discussed any of these topics. Results The percentage of parents who had not discussed each subject with a clinician varied by topic: newborn care (< 3 months old), 38% crying, 65% sleep patterns, 59% encouraging learning, 77% discipline (ages 6-36 months), 75% and toilet training (ages 18-36 months), 66%. Ratings of how well clinicians provide health care. Willingness of parents to pay extra to discuss these topics and receive additional care. ![]() Main Outcome Measures Discussions with a physician or nurse about 6 anticipatory guidance topics and whether parents could use more information on these topics. A stratified random-digit dialing design was used to obtain a nationally representative sample of parents with children between 0 and 3 years old. Objective To determine whether parents are receiving anticipatory guidance, whether they could use more information on anticipatory guidance topics, and how receipt of anticipatory guidance relates to satisfaction with care.ĭesign and Sample Analysis of data from a telephone interview of 2017 respondents between July 1995 and January 1996. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment. ![]()
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