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Content and Emphasis of Well-Child Visits: Experienced Nurse Practitioners vs Pediatricians

Content and Emphasis of Well-Child Visits: Experienced Nurse Practitioners vs Pediatricians Abstract • The content and emphasis of well-child visits conducted by nine randomly selected pediatricians was compared with those of five experienced pediatric nurse practitioners. Twenty one nurse visits and 43 pediatrician visits with 1-year-old to 2-year-old children were monitored. The nurses discussed developmental and child behavior topics in significantly (P <.05) greater depth, they asked more open-ended questions, made more specific recommendations, provided more maternal support, and the parents spoke a greater proportion of the time during the nurses' visits. Efficiency (number and depth of topics considered per unit time) of both groups was similar. Nurse visits were more time-consuming (mean, 25.5 vs 17.6 minutes for pediatricians). A subgroup of four pediatricians conducted visits much like those of the nurses, scoring as well in less time. The other five pediatricians conducted shorter visits, with little emphasis on child development and provided less time for the parent to talk. Overall, after five years in practice, these nurses were in no way less complete in child health supervision than a representative sample of pediatricians and were considerably more comprehensive in their approach than the average pediatrician. (Am J Dis Child 131:794-797, 1977) References 1. Charney E, Kitzman H: The child health nurse in private practice . N Engl J Med 285:1353-1358, 1971.Crossref 2. Day LR, Egli R, Silver HK: Acceptance of pediatric nurse practitioners: Parents' opinion of combined care by a pediatrician and a pediatric nurse practitioner in a private practice . Am J Dis Child 119:204-208, 1970. 3. Duncan B, Smith AN, Silver HK: Comparison of the physical assessment of children by pediatric nurse practitioners and pediatricians . Am J Public Health 61:1170-1176, 1971.Crossref 4. Schiff DW, Fraser CH, Walter HL: The pediatric nurse practitioner in the office of the pediatrician's private practice . Pediatrics 44:62-68, 1969. 5. Silver H, Ford L, Stearly S: A program to increase health care for children: The pediatric nurse practitioner program . Pediatrics 39:756-769, 1967. 6. Hoekelman RA: What constitutes adequate well-baby care . Pediatrics 55:313-326, 1975. 7. Korsch BM, Negrete VF, Mercer AS, et al: How comprehensive are well-child visits? Am J Dis Child 122:483-488, 1971. 8. Starfield B, Berkowe S: Physician's recognition of complaints made by parents about their children's health . Pediatrics 43:168-172, 1969. 9. Stine O: Content and method of health supervision by physicians in child health conferences in Baltimore . Am J Public Health 52:1858-1865, 1962.Crossref 10. Willoughby J, Haggerty R: A simple behavior questionnaire for preschool children . Pediatrics 34:798-806, 1964. 11. Hercules C, Charney E: Availability and attentiveness: Are these compatible in pediatric practice? Clin Pediatr 8:381-388, 1969.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Content and Emphasis of Well-Child Visits: Experienced Nurse Practitioners vs Pediatricians

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References (15)

Publisher
American Medical Association
Copyright
Copyright © 1977 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1977.02120200076017
Publisher site
See Article on Publisher Site

Abstract

Abstract • The content and emphasis of well-child visits conducted by nine randomly selected pediatricians was compared with those of five experienced pediatric nurse practitioners. Twenty one nurse visits and 43 pediatrician visits with 1-year-old to 2-year-old children were monitored. The nurses discussed developmental and child behavior topics in significantly (P <.05) greater depth, they asked more open-ended questions, made more specific recommendations, provided more maternal support, and the parents spoke a greater proportion of the time during the nurses' visits. Efficiency (number and depth of topics considered per unit time) of both groups was similar. Nurse visits were more time-consuming (mean, 25.5 vs 17.6 minutes for pediatricians). A subgroup of four pediatricians conducted visits much like those of the nurses, scoring as well in less time. The other five pediatricians conducted shorter visits, with little emphasis on child development and provided less time for the parent to talk. Overall, after five years in practice, these nurses were in no way less complete in child health supervision than a representative sample of pediatricians and were considerably more comprehensive in their approach than the average pediatrician. (Am J Dis Child 131:794-797, 1977) References 1. Charney E, Kitzman H: The child health nurse in private practice . N Engl J Med 285:1353-1358, 1971.Crossref 2. Day LR, Egli R, Silver HK: Acceptance of pediatric nurse practitioners: Parents' opinion of combined care by a pediatrician and a pediatric nurse practitioner in a private practice . Am J Dis Child 119:204-208, 1970. 3. Duncan B, Smith AN, Silver HK: Comparison of the physical assessment of children by pediatric nurse practitioners and pediatricians . Am J Public Health 61:1170-1176, 1971.Crossref 4. Schiff DW, Fraser CH, Walter HL: The pediatric nurse practitioner in the office of the pediatrician's private practice . Pediatrics 44:62-68, 1969. 5. Silver H, Ford L, Stearly S: A program to increase health care for children: The pediatric nurse practitioner program . Pediatrics 39:756-769, 1967. 6. Hoekelman RA: What constitutes adequate well-baby care . Pediatrics 55:313-326, 1975. 7. Korsch BM, Negrete VF, Mercer AS, et al: How comprehensive are well-child visits? Am J Dis Child 122:483-488, 1971. 8. Starfield B, Berkowe S: Physician's recognition of complaints made by parents about their children's health . Pediatrics 43:168-172, 1969. 9. Stine O: Content and method of health supervision by physicians in child health conferences in Baltimore . Am J Public Health 52:1858-1865, 1962.Crossref 10. Willoughby J, Haggerty R: A simple behavior questionnaire for preschool children . Pediatrics 34:798-806, 1964. 11. Hercules C, Charney E: Availability and attentiveness: Are these compatible in pediatric practice? Clin Pediatr 8:381-388, 1969.Crossref

Journal

American Journal of Diseases of Children – American Medical Association

Published: Jul 1, 1977

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