King's transaction elements identified in adolescents' interactions with health care providers

The purpose of this investigation was to explore adolescents' perceptions of their interactions with health care providers so that interventions can be developed which foster collaborative relationships between health care providers and adolescents. King's (1981) theory of goal attainment provided the theoretical foundation for the study. The research questions focused on the identification of King's (1981) transaction process elements found in the interactions occurring between adolescents and health care providers from the adolescents' perspective.

In this non-experimental investigation, semi-structured interviews were conducted with 50 randomly selected adolescents, between the ages of 12 and 15 years, at five public middle schools, using the Adolescent Transaction Interview Guide. The audiotape recorded interviews were content analyzed for statements reflecting elements of the transaction process and scored according to the strength and number of statements extracted. Intra-rater and inter-rater reliability coefficients were found to be.9818 and.9391, respectively. The study data was summarized using descriptive statistical techniques, and selected demographic variables were correlated with the transaction process score.

Elements of the transaction process were found throughout the perceptions of the adolescents' interactions with health care providers, but only five adolescents' perceptions contained all of the elements of the transaction process. The exchange of value about the health situation, or transaction, was not consistently communicated from the adolescent to the health care provider in the majority of the teenagers' perceptions, exemplifying the traditional active-passive health care relationship. Adolescents citing health problems perceived a greater degree of transaction occurring within the health care encounter. A positive relationship was noted between the frequency of adolescent health care interactions and the exchange of value occurring between the adolescents and their health care providers. The transaction process was found not to correlate with the adolescents' age, sex, race, or educational level.