Pediatric GI Health Care Professionals’ Perceptions of and Engagement With Psychosocial Providers in Pediatric IBD Care

Abstract

Objectives: 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. Methods: 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 t test, and exploratory analyses of variance. Results: 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. Conclusion: 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.

Is it “all in the bag?” Multidisciplinary perspectives on ostomy surgery in pediatric IBD across the ImproveCareNow network

“…Notably, for many ICN sites there are integrated care models for psychosocial health, which may also increase ease and availability of collaborative care with psychologists in these clinical cases. 37 , 38…”

“…Notably, for many ICN sites there are integrated care models for psychosocial health, which may also increase ease and availability of collaborative care with psychologists in these clinical cases. 37,38 Participants endorsed that while collaboration is common, the amount and/or quality of collaboration can be variable in this cohort of patients. This resonates with empirical knowledge of how collaboration can vary depending on many factors including surgery being elective or emergent, patient/family openness to multidisciplinary care, and variability amongst HCPs of knowing who and how other specialties can contribute to care needs (e.g., a GI who is on service and does not specialize in IBD is on service may be less familiar with a WOC nurse's role preoperatively).…”

Variability of Psychosocial Services Within the ImproveCareNow Learning Health System: Opportunities for Optimization

“…Opportunities to optimize psychosocial services across the pediatric IBD care continuum will likely need to include efforts to increase integration of psychosocial care through ongoing discussions related to funding, support leadership at institutions in appreciating the importance and role of psychosocial care in this population, address stigma related to mental health utilization, educate patients and caregivers on potential benefits of psychosocial services, increase exposure to psychosocial care in IBD, and a possible movement toward an “opt-out” versus an “opt-in” model in recognizing the normative psychosocial needs of IBD patients and families ( 11 ). Recommendations from a recent paper discussing integration of psychosocial services in pediatric specialty care also included identifying a physician champion to support integration efforts and pediatric psychologists increasing their profiles and engagement with medical providers ( 18 ).…”