Parents are often well accommodated to their children and know the subtle signs of change, especially for children with chronic or complex conditions.

Psychosocial stressors and the personal perceptions of health and disease that lead patients to seek medical care are not unique to pediatrics. However, what is unique in pediatrics is that fear, anxiety, and stress come from the patients’ parents or caregivers and not the patients themselves.

Personal and past experiences have an interesting and complex role in how, when, and why parents seek care. On one end of the spectrum are children who experienced serious illness in the recent or distant past. Though the child may have made a complete recovery, with no long-term sequelae, the stress of the initial illness has a long-term impact on the parents. This leads parents to be concerned about disease susceptibility. For example, a mother might bring her 8-month-old infant to a clinic with a chief complaint of “runny nose and congestion.” The recent history might be benign, as the mother describes a happy, playful infant, who eats and voids well without fevers, cough, or respiratory distress. The physical exam also might be benign, without significant rhinorrhea or congestion. On further discussion with the mother, she might report that, several months earlier, her child was hospitalized with respiratory syncytial virus (RSV) bronchiolitis, and she had been concerned the infection would recur. Without the knowledge of the previous infection, the provider might offer reassurance that the child does not have a concerning condition. However, without eliciting the mother’s underlying concerns, such as “Will the RSV infection recur?” or “Will my child be hospitalized again?,” the clinician might not address the mother’s fears.