Project details

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Effective elements in consultations with children suffering from persistent somatic symptoms: a clinical cohort study

Keywords:
pediatrics prospective cohort study Persistent somatic symptoms

Researchers:
Prof. dr. J.G.M. Rosmalen
Irma J. Bonvanie
Michel J. van Vliet
Arvid Kamps
Janneke van Leeuwen

Type of project:
Stage Wetenschap / Researchproject

Nature of the research:
Clinical, prospective, observational research. We will extract data from medical files and obtain quantitative data from children and parents by questionnaires before and after consultation with a pediatrician.

Fields of study:
pediatrics psychiatry

Background / introduction
Persistent somatic symptoms (PSS) are symptoms without a univocal biomedical diagnosis. PSS such as headache or fatigue are very common in children and can lead to substantial impairments. The cause of PSS is thought to be multifactorial with psychological, social and biological factors all playing a role. How the diagnosis of PSS is communicated with parents and children is expected to be very relevant for illness perception, acceptance, and (start with) recovery. Yet, surprisingly little is known about current practice of step one treatment in pediatric care, and the supposedly effective elements of this treatment. More insight into working elements of step one treatment can provide more specific evidence-based recommendations for practitioners in the treatment of pediatric patients with PSS. We therefore aim to perform a pilot of a clinical cohort study. The overall aim of the eventual cohort study is to identify the used, appreciated, and working elements in consultations of pediatricians with children and their parents suffering from PSS. With this pilot study we will first focus on a potential factor of influence on PSS practitioners are currently recommended to change in consultation, namely illness perception.
Research question / problem definition
Negative illness perception has been associated with higher levels of PSS and is suggested to be an important perpetuating factor for some children with severe PSS. It is unknown if consultations with pediatricians change these perceptions.
Workplan
For this pilot study, children, parent(s) and/or caregiver(s) referred for PSS to the Martini Hospital Groningen or the UMC Groningen will be asked to fill in a brief questionnaire before the consultation and afterwards. We will also subtract relevant information with regard to patient and symptom characteristics, and follow-up treatment decisions from medical files.

We aim to include 60 pediatric patients in this study. We expect this to take around 12-14 weeks. During this phase data are gathered, the database is build and introduction and method sections can be written. In the final six weeks of the research project the student can focus on analyzing the data and finalizing the results and discussion section.

During the research project, the student will primarily be based at the pediatric department of the Martini Hospital Groningen.

This pilot study of setting up a clinical cohort will also have a follow-up part (at six and twelve months) and will, when proved feasible, be expanded to investigate more potential factors influencing the course of PSS in children, and enriched with a qualitative interview study.

Start of this pilot study: Between sept-nov 2023.
Aimed start of a qualitative interview study is march 2024.
Start of follow-up parts of this pilot study will be around march 2024 and again between September-November 2024.
References
Nederlandse Vereniging Kindergeneeskunde (NVK). Richtlijn somatisch onvoldoende verklaarde lichamelijke klachten (SOLK) bij kinderen [Internet]. 2019 [cited 2023 Mar 6]. Available from: https://www.nvk.nl/themas/kwaliteit/richtlijnen/richtlijn?componentid=6488085&tagtitles=Maag-Darm-Leverziekten%252b(MDL)%2CNeonatologie%2CSociale%252ben%252bPsychosociale%252bkindergeneeskunde

NGH-Richtlijnen. Somatisch onvoldoende verklaarde lichamelijke klachten (SOLK) [Internet]. 2013 [cited 2023 Mar 6]. Available from: https://richtlijnen.nhg.org/standaarden/somatisch-onvoldoende-verklaarde-lichamelijke-klachten-solk

Janssens KA, Klis S, Kingma EM, Oldehinkel AJ, Rosmalen JG. Predictors for persistence of functional somatic symptoms in adolescents. J Pediatr. 2014 Apr;164(4):900-905.e2.
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