Urban female teenagers' perceptions of medical communication.

ABSTRACT Although it is clear that health care must be age-appropriate to be effective, little is known about the care-related preferences of adolescent females. The purpose of this study, therefore, was to examine teenagers' preferences in regard to medical communication, so that care providers in a number of disciplines can make their interactions with young females more satisfactory and successful. Specifically, examples of female teenagers' best and worst encounters with physicians are reported. It was found that female teenagers prefer physicians who comfort, use humor, are understanding, and explain procedures. Physicians who rush, behave rudely, or are "too personal" are viewed negatively. It was concluded that relational communication skill development must be a priority of educators and service providers if caregiving is to be maximized with this important patient group. Without communication between physicians and patients, health care would be little more than folly: diagnostic accuracy is dependent upon the ability to procure a medical history. The literature confirms the importance of care provider-patient interaction. For example, satisfaction with care and compliance with treatment have long been linked to communication in the medical encounter (see Burgoon, Pfau, Parrott, Birk, Coker, & Burgoon, 1987; Hall & Dornan, 1988; Korsch, Freemon, & Negrete, 1971). Physicians seem to treat patients differently depending on their ethnicity (Singer, 1991), age (Levenson, 1985; Parra & Espino, 1992), socioeconomic status (Pendleton & Bochner, 1980), and disease type (Mizrahi, 1986). Thus, patients' experiences are not monolithic. The same holds true for their needs (see Blea, 1992; Gaw, 1993). One group in particular has received little attention in terms of their medical experiences and needs--adolescent patients, especially females. Based on findings about the relationship between compliance and communication (Feinberg, 1988; Roter, Hall, & Katz, 1988), it is likely that adolescents' perceptions and attitudes regarding communication with physicians will affect the manner in which they care for themselves and their future families-a compelling reason to study this patient group. Researchers note the importance of culturally relevant (Frye, 1995; Yeh, Takeuchi, & Sue, 1994) and age-appropriate health programs (Babor, del-Boca, Mclaney, & Jacobi, 1991; Bechtold, 1994; Court, 1991; Dilorenzo, Abramo, Hem, & Clare, 1993; Herring, 1994; Laurendeau, Perreault, & Mongeon, 1991; Smith & Weinman, 1995). Geography also dictates health messages: urban adolescents display health behaviors that are different from those of rural teenagers (see Farrow & Schwartz, 1992; Keller, Bartlett, Schleifer, & Johnson, 1991). While interventions have been specifically designed for teens (see, for example, Babor, del-Boca, Mclaney, & Jacobi, 1991; Cohen, MacKenzie, & Yates, 1991), the effectiveness of such programs is limited if they are based solely on what adults think health care for teenagers should be. Indeed, the communication of medical information, which is attempted in many social programs, is best evaluated by those most affected (see Denzin, 1988, for an explanation of the link between private prob lems and public programs). The purpose of this study, therefore, was to examine teenagers' preferences in regard to medical communication, so that care providers in a number of disciplines can make their interactions with young females more satisfactory and successful. THE ROLES OF PERCEPTION AND COMMUNICATION Perception influences communication: it affects the assignment of meaning to events and people (Roloff & Berger, 1982). Communication is shaped by context, prior interactions, expectations, and socioeconomic and demographic factors. Schemata allow understanding and prediction of events, as well as behavioral and communicative responses (see Kelly, 1955; Kelley, 1967, 1973). …