Interviews with 60 parents of children attending a rheumatic fever clinic showed confusion and many unrealistic beliefs about the disease and its long-term effects, about recurrences, and about the rationale for the prophylactic program. The parents' all-pervading anxiety about heart disease and death led them to impose or continue restrictions contrary to medical advice, even on children with normal hearts.
The mothers' lack of understanding correlated with their level of education and a number of social and environmental factors. One group of families with a clearly defined pattern of social characteristics-almost entirely Negro, on public assistance, with a low educational level, a very low income, and a high degree of family disorganization-stood out because of its lack of understanding about the disease and about its prophylactic treatment.
The responses of Negro mothers on public assistance as well as those with higher educational and income levels were similar in several respects and differed from those of Caucasian mothers. On the basis of what the mothers reported, communication about the disease was remarkably poor between physician and parent, parent and child, and physician and patient.
- Received October 6, 1967.
- Accepted July 20, 1968.
- Copyright © 1969 by the American Academy of Pediatrics