Table 1.

Barriers in obtaining routine outpatient CF throat cultures.

Parent/caregiver

Understanding of clinical disease and processes

Anxiety about child’s discomfort

Anger or frustration toward clinical care provider(s)

Difficulty with limit-setting

Length of outpatient visit

Child

Understanding and self-awareness of disease

Anxiety and frustration Prior experiences with stressful procedures Exhibition of behavioral distress (e.g., crying and yelling)

Delay and avoidant behavior Requests for parent to perform throat culture Elopement from examination room

Clinical care provider(s)

Response to cooperation of child and parent

Changing clinical management approach Prior unsuccessful attempts and delayed procedures Decision-making based on available clinical data

Length and efficiency of outpatient visit