Anxious parents' advocacy styles may affect their kids' medical care. Nancy Big Crow, Flickr CC

Helicopter Parents in the Hospital

How far can parents go when advocating for their sick child? Better yet, how far will doctors allow them to go? Elizabeth Gage-Bouchard, writing in the Journal of Health and Social Behavior, delves into parental advocacy and unequal healthcare experiences by examining how parents’ communication styles can either negatively or positively contribute to their child’s medical outcomes.

Gage-Bouchard chose a single hospital in which to study families with a child being treated for cancer. She conducted in-depth interviews with 80 parents and all of the oncology doctors on staff. She also carried out extensive participant observations of interactions between parents and doctors, determining parents’ advocacy styles and noting doctors’ responses.

The parents’ advocacy styles fell into three categories Gage-Bouchard labeled vigilant, trusting, and antagonistic. Vigilant advocacy was marked by active monitoring of the child’s treatment, trusting advocacy by deference to physician’s expertise, and antagonistic advocacy by confrontational interactions with physicians. These styles then corresponded to class: parents from upper- and middle-class families mostly used vigilant advocacy, drawing on their cultural knowledge to build collaborative relationships with doctors, while working-class families most often used trusting advocacy (and, less often, antagonistic advocacy). Doctors appreciated trusting parents, especially those who followed their recommendations, but they had the most rapport with the higher-status parents who demonstrated vigilant advocacy.

The results confirm that parenting styles, and parents’ levels of involvement and interactions with their child’s physicians, can affect how physicians perceive—and respond to—children in their care. The research may help us understand how interpersonal interactions contribute to class differences in healthcare experiences.