Abstract

NUNES, C.  and  AYALA, M.. Advice or prescription?: analysis of the pediatric recommendations in the healthy child program visits. Rev Pediatr Aten Primaria [online]. 2013, vol.15, n.60, pp.e135-e143. ISSN 1139-7632.  https://dx.doi.org/10.4321/S1139-76322013000500003.

Introduction: reasoning the recommendations increases mothers’ adherence and satisfaction in the healthy child program visits. A recommendation can be considered an advice or a prescription according to its reasoning. Aims: in this study we described and analyzed the use of advice and prescription in the recommendations made by pediatricians to mothers in the healthy child program visits. We analyzed the quantity and quality of recommendations, its content and its relation to the visits’ duration, and the characteristics of the child and mother. Methods: we audio-taped 50 visits of five pediatricians and we classified, through content analysis, the recommendations in six categories: secondary prevention, primary prevention, health promotion, development, education and family relationships. >Results: pediatricians made 4.37 recommendations per visit, 69% by their own initiative and 31% by mothers’ request. Pediatricians make recommendations mainly about health promotion (32.87%), secondary prevention (17.13%) and primary prevention (10.19%). The amount of recommendations was positively associated with the visit’s length (M=16.10 minutes) and negatively related with child’s age. The pediatricians used much more advice (70%) than prescription (30%). The effect of the mothers’ educational level wasn’t observed. Conclusions: there was a great heterogeneity between pediatricians in all observed variables; this suggests that there exist different pediatric styles whose characteristics and effects deserve further investigation in future studies in order to help pediatricians to improve their professional practice.

Keywords : Pediatricians; Healthy Child; Program; Advice; Prescription; Recommendations; Primary Health Care.

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