{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:15:33Z","timestamp":1777860933649,"version":"3.51.4"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["1R01NR020005"],"award-info":[{"award-number":["1R01NR020005"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007928","name":"Perelman School of Medicine, University of Pennsylvania","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007928","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Time alone between adolescents with chronic illnesses and their clinicians may contribute to patient\u2010centred care and transition readiness within this population. Shifts in the adolescent\u2013parent\u2013clinician relationship underpin this contribution; as such, this qualitative study explored adolescent, parent and clinician perspectives on time alone in routine visits for paediatric chronic illness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Semi\u2010structured interviews with English\u2010speaking adolescents (ages 12\u201317,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200965) and their parents (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200963) were conducted after follow\u2010up visits for inflammatory bowel disease (IBD), juvenile idiopathic arthritis (JIA), sickle cell disease (SCD) or type 1 diabetes (TID) at specialty clinics affiliated with the Children's Hospital of Philadelphia. Clinicians (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916) at the same clinics were also interviewed for this cross\u2010sectional qualitative study. Interviews were transcribed, and thematic analysis was performed using an inductive approach.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Qualitative analysis yielded six themes: (1) Clinician, parent and adolescent factors influence provision of time alone; (2) some adolescents communicate more openly with their clinician during time alone; (3) some adolescents do not share new information during time alone; (4) time alone facilitates the development of the clinician\u2010adolescent relationship and helps prepare the adolescent for the transition to adult care; (5) clinicians continuously re\u2010negotiate the parent\u2013adolescent\u2013clinician relationship to meet adolescents' needs; and (6) time alone can raise challenges for clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Time alone can affect information sharing and relationship building between adolescents with chronic illnesses and their clinicians. By fostering open communication and trust in the adolescent\u2013clinician relationship, time alone may help prepare adolescents with chronic illnesses for the transition to adult care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cch.70147","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T07:21:19Z","timestamp":1754378479000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adolescent, Parent and Clinician Perspectives on Time Alone in Chronic Illness Visits at a Single Children's Hospital"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2736-5187","authenticated-orcid":false,"given":"Eleanor","family":"Lustig","sequence":"first","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Alfonso\u00a0L.","family":"Floyd","sequence":"additional","affiliation":[{"name":"Division of Adolescent Medicine Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth\u00a0A.","family":"Friedrich","sequence":"additional","affiliation":[{"name":"Division of Adolescent Medicine Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morgan","family":"Snyder","sequence":"additional","affiliation":[{"name":"Division of Adolescent Medicine Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria\u00a0A.","family":"Miller","sequence":"additional","affiliation":[{"name":"Division of Adolescent Medicine Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Department of Pediatrics, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2022.05.021"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6530a2"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1054\u2010139x(03)00047\u20108"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.17226\/25388"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2003-1134-L"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1145\/3491102.3502055"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.269.11.1404"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102524.2005.00577.x"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2013.11.024"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2009.09.003"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2004.03.002"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.23.2227"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2010.10.004"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03550120089044"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892\u2010012\u20100311\u20106"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2014.05.016"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03520480033036"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1525822X05279903"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1542\/9781610020237"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1054\u2010139x(98)00146\u20103"},{"issue":"8","key":"e_1_2_14_22_1","first-page":"679","article-title":"Earning Trust and Losing It: Adolescents' Views on Trusting Physicians","volume":"54","author":"Klostermann B. 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