David Jennie G, Sejkora Ellen, Michel Hilary K, Mackner Laura
From the Nationwide Children's Hospital, Columbus, OH.
Department of Pediatrics, The Ohio State Wexner Medical Center, Columbus, OH.
JPGN Rep. 2023 Apr 18;4(2):e305. doi: 10.1097/PG9.0000000000000305. eCollection 2023 May.
Multidisciplinary care is recommended for optimal pediatric inflammatory bowel disease (IBD) care, including psychosocial providers (eg, psychologists). However, health care professionals' (HCPs) perceptions of and engagement with psychosocial providers in pediatric IBD is lacking.
Cross-sectional REDCap surveys were completed by HCPs (eg, gastroenterologists) across American ImproveCareNow (ICN) centers. Demographics and self-reported perceptions of and engagement with psychosocial providers were collected. Data were analyzed at participant and site levels through descriptives, frequencies, an independent test, and exploratory analyses of variance.
A total of 101 participants from 52% of ICN sites participated. Participants were 88% gastrointestinal physicians, 49% identifying as female, 94% non-Hispanic, and 76% Caucasian. Of ICN sites, 75% and 94% of sites reported outpatient and inpatient psychosocial care, respectively. Participants referred for various clinical reasons to psychosocial providers (eg, illness adjustment). At the participant level, 92% of HCPs reported psychosocial care was very important and 64% reported their clinical thresholds shifted to engage psychosocial providers earlier in care. Barriers to psychosocial care included limited psychosocial providers (92%), psychosocial providers availability (87%), and IBD patients' lack of openness to psychosocial care (85%). One-way analyses of variance by HCP length of experiences were not statistically significant on perceived understanding of psychosocial providers or perceived changes in clinical threshold over time.
HCPs overall reported positive perceptions of and frequent engagement with psychosocial providers in pediatric IBD. Limited psychosocial providers and other notable barriers are discussed. Future work should continue interprofessional education of HCPs and trainees and efforts to improve access to psychosocial care in pediatric IBD.
推荐采用多学科护理以实现最佳的儿童炎症性肠病（IBD）护理，包括心理社会服务提供者（如心理学家）。然而，医疗保健专业人员（HCPs）对儿童IBD心理社会服务提供者的认知以及与之的合作尚显不足。
美国改善医疗护理网络（ICN）各中心的HCPs（如胃肠病学家）完成了横断面REDCap调查。收集了人口统计学信息以及自我报告的对心理社会服务提供者的认知和合作情况。通过描述性统计、频率分析、独立t检验以及方差探索性分析在参与者和机构层面进行数据分析。
来自52%的ICN机构的101名参与者参与了调查。参与者中88%为胃肠科医生，49%为女性，94%为非西班牙裔，76%为白种人。在ICN机构中，分别有75%和94%的机构报告提供门诊和住院心理社会护理。参与者因各种临床原因将患者转介给心理社会服务提供者（如疾病适应问题）。在参与者层面，92%的HCPs报告心理社会护理非常重要，64%的HCPs报告他们的临床阈值发生了变化，从而在护理早期就与心理社会服务提供者合作。心理社会护理的障碍包括心理社会服务提供者数量有限（92%）、心理社会服务提供者的可及性（87%）以及IBD患者对心理社会护理缺乏接受度（85%）。按HCPs工作经验时长进行的单因素方差分析在对心理社会服务提供者的认知理解或临床阈值随时间的感知变化方面无统计学意义。
总体而言，HCPs报告对儿童IBD心理社会服务提供者有积极的认知且经常与之合作。文中讨论了心理社会服务提供者数量有限及其他显著障碍。未来的工作应继续对HCPs和实习生进行跨专业教育，并努力改善儿童IBD心理社会护理的可及性。
