# Characteristics of Interaction Between Caregivers and Children with Chronic Diseases in Oral Medication-Taking Situations: A Validation Study of the Interaction Rating Scale

## TL;DR

This study validates a tool to assess how caregivers and children interact during medication-taking, showing it is reliable and useful for understanding these interactions.

## Contribution

The study validates the Interaction Rating Scale for evaluating caregiver–child interactions in medication-taking situations.

## Key findings

- The IRS showed high internal consistency, test–retest, and inter-rater reliability.
- IRS scores were partially associated with parenting and social skills scales as expected.
- The IRS is a reliable instrument for measuring caregiver–child interactions during medication-taking.

## Abstract

Caregiver–child interaction is essential for maintaining adaptive oral medication-taking behavior in children. To evaluate interactive behavior between children and caregivers, the Interaction Rating Scale (IRS), an observation-based instrument for evaluating the quality of caregiver–child interaction, can be applied via observation of interactions. This study examined the applicability of the IRS in oral medication-taking situations.

Sixty-six caregiver-child dyads were evaluated using the IRS. The reliability of the measure was evaluated using Cronbach’s alpha for internal consistency and intra-class coefficient (ICC) for inter-rater reliability and test–retest reliability. The concurrent validity was evaluated using the Positive and Negative Parenting Scale and the Social Skills Scale for Preschool Children.

The IRS total, caregiver, and child scores showed high internal consistency (α = 0.86–0.92), test–retest reliability (ICC = 0.76–0.80) and inter-rater reliability (ICC = 0.86–0.91). The IRS indices were partially associated with the Positive and Negative Parenting Scale and Social Skills Scale scores in the hypothesized directions.

The results indicated the IRS is a reliable and validated instrument for measuring characteristics of caregiver–child interactions in medication-taking situations. Further studies may be helpful for validating the measure in wider patient groups and investigating the medication behavior of children.

The online version contains supplementary material available at 10.1007/s10995-025-04099-2.

Inappropriate medication behavior can lead to negative consequences for patients. Prior research has suggested that parental involvement is an essential factor in maintaining children's good medication-taking behaviors, while validated measures of the quality of caregiver–child interactions are not available. This study examined the applicability of the Interaction Rating Scale in medication situations as a measure of the quality of the interaction between children and caregivers. The finding supports the use of the measure for assessing caregiver–child interactions in medication-taking situations. A behavioral measure of caregiver–child interactions may help future research to develop good medication-taking behaviors in children.

The online version contains supplementary material available at 10.1007/s10995-025-04099-2.