Children in chronic pain: Promoting pediatric patients' symptom accounts in tertiary care

Ignasi Clemente, Seung Hee Lee, John Heritage

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


This paper examines how clinicians promote pediatric patients' symptom accounts at the beginning of visits in three pediatric tertiary care clinics at a university hospital in the United States: pain, gastroenterology and neurology. Quantitative and qualitative data were collected for 69 patient-parent pairs, including videotaped intake visits. Two forms of child account promotion, together with their corresponding distribution across clinics, were identified: (1) Epistemic prefaces were used to upgrade the patient's epistemic status and to establish the child as primary informant; and, (2) non-focused questioning was used to permit children latitude in the formulation of symptoms and experiences. In general, epistemic prefaces were characteristic of the gastroenterology and neurology visits, while non-focused questioning was found overwhelmingly in the pain encounters.

Original languageEnglish
Pages (from-to)1418-1428
Number of pages11
JournalSocial Science and Medicine
Issue number6
Publication statusPublished - 2008 Mar

Bibliographical note

Funding Information:
Research for this article was supported by the National Institute of Mental Health: Grant No. NIMH/R01 MH63 779, P.I: M. Jacob.

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • History and Philosophy of Science


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