Parent and adolescent perspectives on decision-making involvement: A qualitative comparison in sickle cell and diabetes clinics.

The findings come from a single urban academic pediatric hospital, so they may not apply to other clinics or settings. Participants were adolescents and parents, not clinicians, so clinician behaviors were inferred from adolescent and parent reports rather than observed or reported by clinicians. Adolescents with sickle cell disease were seen by physicians, while adolescents with diabetes were seen by nurse practitioners, so differences between groups may reflect clinician type rather than illness. The sample was mainly English-speaking mothers, limiting relevance to fathers, other caregivers, and families who speak other languages. The study did not account for adolescent age or gender, which can influence decision-making involvement. Illness groups were used as a comparison, but race was not directly examined, so differences cannot be separated from racial or ethnic factors. Interviews were based on recall of a recent visit and were conducted by phone, so they may not capture all details of the clinic interaction.

Do not read these themes as evidence that a communication strategy improves outcomes. They describe perceptions from interviews at a single hospital, and the study did not test any intervention.