Specialists Understanding of the Health Care Preferences of Chronically Ill Adolescents

Studies that focus on adults have shown that patient-centered health care promotes improved health outcomes and satisfaction with care, yet there has been little exploration of the health preferences of adolescents. This article addresses this gap by exploring whether subspecialty physicians who care for chronically ill adolescents understand their patients' health preferences. In a survey designed to compare their responses, 155 adolescents with chronic illnesses and 52 subspecialty physicians recruited from the same clinics of a children's hospital rated the importance that adolescents place on items relating to quality of care and physician-patient communication styles.

Key Findings:

  • In regard to quality of care, both physicians and patients ranked pain management as the most important issue, but physicians underestimated the importance adolescents placed on technical aspects of care.
  • For communication items, 13 out of 17 physicians' responses were significantly different than those of adolescents. In particular, physicians tended to overestimate adolescents' desire for autonomy and confidentiality, especially of illness-related information.

Disagreements in key areas, such as autonomy, communication and confidentiality suggest that physicians should not assume they know the preferences of adolescents in these areas, but rather assess them directly.