Table 6 Parent immediate response to clinician treatment recommendations

Acknowledgement

“I don’t think we need to do anything. I think you’re doing all the right things in terms of lots of rest, lots of fluid. Calpol if he needs it. But I don’t think – if he’s like this I wouldn’t worry about. ”(C214: GP)

“Right, okay.” (P23: father)

“it’s probably worth starting a course of antibiotics.” (C214: GP)

“Okay.” (P54: mother)

“I’ll give you just the puffer as a precaution for the next week, alright.” (C215: GP)

“Yeah.” (P26: mother)

Active Acceptance

“I don’t think she needs antibiotics today” (C224: NP)

“No, … no and to be honest I’d rather she didn’t” (P65: mother)

Interactional resistance

GP: “She does have an ear infection …. usually they will recover within 5 days, and that’s not sped up by taking antibiotics. … I think [give it] 5 days if she doesn’t become unwell in herself.”

Father: “So if she does basically um, after 5 days, just then, what, just go to the er local um pharmacy and get some um?”

GP: “Well after – what I’ll do is I’ll give you a prescription now for some antibiotics.” (C205:GP)

Father: “Okay.” (P13: father)

“if we treat the ear infection [with antibiotics], she’ll feel a bit better in herself … The cough should, sort of, limit on its own. However, if she’s worse, you think the cough’s worse, or you’re worried about her breathing, then come back.” (C220: NP)

“Yeah. Is there, erm, anything that kind of helps with her [cough]?” (P40: mother)

“Her chest in completely clear. But actually, oddly, the paeds A&E consultants will say that if a child complains of chest pain … it is a pneumonia until you can prove otherwise.

… I would actually say in this case she probably would benefit from a 5 day course of antibiotics.” (C207: GP)

“Because she’s complaining about pain?” (P19: mother)