The Golden Half Hour in Chronic Pediatric Pain—Feedback as the First Intervention

Schechter, Neil L.; Coakley, Rachael; Nurko, Samuel

doi:10.1001/jamapediatrics.2020.1798

Cited by 16 publications

(20 citation statements)

References 4 publications

(9 reference statements)

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“…[71][72][73] However, with the pediatric population, the provider needs to consider the patient's developmental stage and establish a relationship with the child or adolescent and the parents/ caregivers. 74 Development. Providers must be considerate of the child or adolescent's developmental age when gathering details of the patient's symptom experience, asking questions, and providing explanations.…”

Section: Pediatric Factorsmentioning

confidence: 99%

“…Pediatric providers must recognize patient anxiety and mood symptoms throughout a clinic visit. 74 Avoidance of or dismissal of overt symptoms and signs of anxiety or depression, such as poor eye contact, tearfulness, behavioral regression, or agitation, may reduce patient trust in the provider and significantly impact the development of an effective PPR over time.…”

Section: Pediatric Factorsmentioning

confidence: 99%

“…100,101 Finally, for a pediatric gastroenterologist, the presence of an anxious parent in a clinic visit can influence the tone of the visit and how the provider can provide evaluation and feedback. 74,89 Parents might present to the visit with a strong desire to receive a "correct" diagnosis, coupled with feelings of helplessness 71,74,89,102 ; consequently, they might present as overly assertive and emotional, which, in turn, can result in a tendency to speak for or over the child. Parents might also struggle to truly hear feedback, given their heightened arousal, particularly if the feedback provided about the diagnosis and treatment is ambiguous or incongruent with visit expectations.…”

Section: Pediatric Factorsmentioning

confidence: 99%

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A Review of the Evidence and Recommendations on Communication Skills and the Patient–Provider Relationship: A Rome Foundation Working Team Report

et al. 2021

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BACKGROUND & AIMS: Over several decades, changes in health care have negatively impacted meaningful communication between the patient and provider and adversely affected their relationship. Under increasing time pressure, physicians rely more on technology than face-to-face time gathering data to make clinical decisions. As a result, they find it more challenging to understand the illness context and fully address patient needs. Patients experience dissatisfaction and a diminution of their role in the care process. For patients with disorders of gut-brain interaction, stigma leads to greater care dissatisfaction, as there is no apparent structural basis to legitimize the symptoms. Recent evidence suggests that practical communication skills can improve the patient-provider relationship (PPR) and clinical outcomes, but these data are limited. METHODS: The Rome Foundation convened a multidisciplinary working team to review the scientific evidence with the following aims: to study the effect of communication skills on patient satisfaction and outcomes by performing an evidence-based review; to characterize the influence of sociocultural factors, health care system constraints, patient perspective, and telehealth on the PPR; to review the measurement and impact of communication skills training on these outcomes; and to make recommendations to improve communication skills training and the PPR. RESULTS: Evidence supports the fact that interventions targeting patientprovider interactions improve population health, patient and provider experience, and costs. Communication skills training leads to improved patient satisfaction and outcomes. The following are relevant factors to consider in establishing an effective PPR: addressing health care system constraints; incorporating sociocultural factors and the role of gender, age, and chronic illness; and considering the changing role of telehealth on the PPR. CONCLUSIONS: We concluded that effective communication skills can improve the PPR and health outcomes. This is an achievable goal through training and system change. More research is needed to confirm these findings.

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Section: Pediatric Factorsmentioning

confidence: 99%

Section: Pediatric Factorsmentioning

confidence: 99%

Section: Pediatric Factorsmentioning

confidence: 99%

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A Review of the Evidence and Recommendations on Communication Skills and the Patient–Provider Relationship: A Rome Foundation Working Team Report

et al. 2021

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“…Below are several resources that are helpful for those providers who would like to start integrative psychogastroenterological care in their clinics: Tips for physicians on how to help a family engage with an evidence-based treatment plan for chronic pain as explained by Schechter and colleagues [ 44 ]. How to talk to patients about chronic pain can be found in Coakley and Schechter [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

“…Tips for physicians on how to help a family engage with an evidence-based treatment plan for chronic pain as explained by Schechter and colleagues [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Psychogastroenterology: A Cure, Band-Aid, or Prevention?

Tilburg

2020

Children

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Psychogastroenterology is a field that focuses on the brain–gut connection. Many children with gut disorders also struggle with psychological and social factors that affect their disease outcomes. Psychological factors have been suggested to be a cure, a band-aid, or a prevention. This article examines the underlying models of disease and health that determine how we understand and treat psychosocial factors in gut diseases. The biomedical and biopsychosocial models are presented and applied to pediatric gut disorders. This article should familiarize clinicians as well as children and their families to the challenges and opportunities for addressing psychosocial factors in gut disease. Psychogastroenterology is best thought of as a cog in a complex treatment machine.

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A therapeutic guide on pediatric irritable bowel syndrome and functional abdominal pain-not otherwise specified

et al. 2022

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Disorders of the gut-brain interaction negatively impact quality of life and carry a substantial socioeconomic burden. Irritable bowel syndrome (IBS) and functional abdominal pain-not otherwise specified (FAP-NOS) are common functional abdominal pain disorders in childhood. The pathophysiology is not fully understood, and high-quality intervention trials and international guidelines are missing. Therefore, the management of these disorders remains challenging. This review aims to provide an up-to-date overview of therapeutic possibilities for pediatric IBS or FAP-NOS and recommends management strategies. To prevent unnecessary referrals and extensive costs, it is fundamental to make a positive diagnosis of IBS or FAP-NOS in children with chronic abdominal pain with only minimal investigations. A tailor-made approach for each patient, based on the accompanying physical and psychological symptoms, is proposed to date.Conclusion: Shared decision-making including non-pharmacological and pharmacological interventions should be considered and discussed with the family. What is Known:• Irritable bowel syndrome and functional abdominal pain-not otherwise specified are common in childhood.• Although the number of treatment options has grown recently, managing these disorders can be challenging and unsatisfactory, and no evidence-based international management guidelines are available. What is New:• We suggest using a stepwise individualized approach to management, where after first-line management, both non-pharmacological and pharmacological interventions should be discussed.

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The Golden Half Hour in Chronic Pediatric Pain—Feedback as the First Intervention

Cited by 16 publications

References 4 publications

A Review of the Evidence and Recommendations on Communication Skills and the Patient–Provider Relationship: A Rome Foundation Working Team Report

A Review of the Evidence and Recommendations on Communication Skills and the Patient–Provider Relationship: A Rome Foundation Working Team Report

Psychogastroenterology: A Cure, Band-Aid, or Prevention?

A therapeutic guide on pediatric irritable bowel syndrome and functional abdominal pain-not otherwise specified

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