Sood Erica, Pinder Wendy, Pendley Jennifer S, Fisher Alicia O, Wali Prateek D, del Rosario Fernando
*Division of Behavioral Health, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE; †Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE; ‡Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA; §Department of Biomedical Research, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE; ‖Division of Gastroenterology, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.
J Dev Behav Pediatr. 2016 Apr;37(3):205-12. doi: 10.1097/DBP.0000000000000277.
To examine the role of provider communication about psychosocial causes of abdominal pain and recommendations for psychosocial intervention during a gastroenterology clinic visit in predicting families' causal beliefs and perceptions of treatment acceptability.
Participants were 57 children with a diagnosed or suspected abdominal pain-related functional gastrointestinal disorder (FGID) presenting for an outpatient gastroenterology follow-up visit and their accompanying parent. Children and parents completed questionnaires assessing child anxiety and abdominal pain severity, recall of provider communication about causes of abdominal pain and recommendations for intervention, their own causal beliefs about pain, and perceived acceptability of cognitive behavioral therapy (CBT) and standard medical treatment (SMT) after reading descriptions of each treatment. Providers completed a questionnaire assessing their perceptions and communication about the causes of the child's abdominal pain and perceived acceptability of CBT.
Provider communication about psychosocial causes and interventions was reported infrequently by parents, children, and providers. Parents rated psychosocial causes for abdominal pain as less likely than physical causes, and children and parents rated CBT as less acceptable than SMT. Parents' recall of provider communication about psychosocial causes was associated with their own causal beliefs about pain and their perceived acceptability of CBT. Children's and parents' recall of provider recommendations for psychosocial intervention was associated with their perceived acceptability of CBT.
Results highlight the importance of provider communication about psychosocial contributors to abdominal pain and psychosocial interventions for children with FGIDs. Medical and mental health providers can partner to deliver care to children with FGIDs using a biopsychosocial approach.
探讨在胃肠病门诊就诊期间，医疗服务提供者就腹痛的社会心理原因进行沟通以及提出社会心理干预建议，对预测家庭的病因信念和治疗可接受性认知的作用。
研究对象为57名被诊断或疑似患有腹痛相关功能性胃肠病（FGID）前来门诊进行胃肠病学随访的儿童及其陪同家长。儿童和家长完成问卷调查，评估儿童焦虑和腹痛严重程度、对医疗服务提供者关于腹痛原因及干预建议的回忆、他们自己对疼痛的病因信念，以及在阅读每种治疗方法的描述后对认知行为疗法（CBT）和标准药物治疗（SMT）的可接受性认知。医疗服务提供者完成一份问卷，评估他们对儿童腹痛原因的认知和沟通情况以及对CBT的可接受性认知。
家长、儿童和医疗服务提供者报告，很少有关于社会心理原因和干预措施的沟通。家长认为腹痛的社会心理原因比身体原因可能性小，儿童和家长认为CBT不如SMT可接受。家长对医疗服务提供者关于社会心理原因沟通的回忆，与他们自己对疼痛的病因信念及其对CBT的可接受性认知相关。儿童和家长对医疗服务提供者社会心理干预建议的回忆，与他们对CBT的可接受性认知相关。
研究结果凸显了医疗服务提供者就腹痛的社会心理因素及FGID儿童的社会心理干预进行沟通的重要性。医学和心理健康服务提供者可以合作，采用生物心理社会方法为FGID儿童提供护理。
