The role of incongruence between the perceived functioning by patients and clinicians in the detection of psychological distress among functional and motor digestive disorders

Rodríguez‐Urrutia, Amanda; Eiroá-Orosa, Francisco José; Accarino, Anna; Malagelada, Carolina; Azpiroz, Fernando

doi:10.1016/j.jpsychores.2017.06.005

Cited by 4 publications

(6 citation statements)

References 56 publications

(66 reference statements)

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“…By reconsidering the central role of symptoms, it is conceivable that multiple interconnected neuromuscular, anatomical, and psychological factors concur in the pathophysiology of such symptoms and that the results of this complex interaction are only marginally captured by the current tests. In addition, the discrepancy between the narrative of patients’ symptoms and the results of pathophysiological investigations support the hypothesis that psychological factors, not currently assessed during the clinical evaluation, might be involved in patients’ suffering 30 …”

Section: Clinical Utility Of a Diagnostic Test According To Evidence‐mentioning

confidence: 68%

Seated anorectal manometry during simulated evacuation: A physiologic exercise or a new clinically useful diagnostic test?

Basilisco

Corsetti

2020

Neurogastroenterology Motil

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Symptoms such as a feeling of incomplete evacuation, straining, absence of the call to stool, anal blockage, or digitation suggest the presence a functional defecation disorder. As symptoms do not distinguish between patients with and without functional defecation disorder, Rome IV criteria recommend that this disorder is diagnosed when two of three tests are positive: balloon expulsion test (BET), anorectal manometry (ARM), and defecography. However, previous studies have demonstrated that the agreement among these tests is limited. In this issue of Neurogastroenterology and Motility, Sharma et al tested the hypothesis that conducting the ARM in a seated position would increase the diagnostic accuracy of the test in discriminating between patients with normal and prolonged BET. This minireview discusses the current knowledge on the role of the techniques to diagnose defecation disorder and the potential role of the ARM in a seated position.

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Section: Clinical Utility Of a Diagnostic Test According To Evidence‐mentioning

confidence: 68%

Seated anorectal manometry during simulated evacuation: A physiologic exercise or a new clinically useful diagnostic test?

Basilisco

Corsetti

2020

Neurogastroenterology Motil

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“…To fill this gap, the current study adopted a mixed methods approach by combining quantitative and qualitative data collection methods. The aim of the first stage of the research was to test the hypothesis that the incongruence between the perception of quality of life of patients and gastroenterologists correlates with psychological distress, adopting a similar procedure that was already conducted in tertiary care [17] but applying it to primary healthcare settings. A sequential approach was adopted (see Figure 1) to identify patients with incongruent views of their functionality with their gastroenterologists that could take part in the second stage of the study, which consisted of exploring the perceptions of patients and practitioners through focus groups and interviews, respectively.…”

Section: The Present Studymentioning

confidence: 99%

“…The physical functioning subscale from the SF-36 questionnaire was included to be able to assess the incongruence between gastroenterologists and patients with the same parameters as in former studies [17]. This subscale measures the person's ability to perform different physical activities in an ascending effort gradient in a range from 0 to 100.…”

Section: Instruments Demographicsmentioning

confidence: 99%

“…This study involved assessing the incongruence between the clinician's assessment and the patients self-reported functionality. Using the same premise that was adopted in a previous study [17], patients were identified as having incongruent views with the gastroenterologist by using a value of 25 or greater on the difference between the KPS and the physical functioning subscale of the SF-36.…”

Section: Determination Of Incongruence Between Clinicians' Assessment...mentioning

confidence: 99%

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Incongruent Views of Functioning between Patients and Gastroenterologists: A Mixed Methods Study

et al. 2022

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Gastrointestinal patients, especially those diagnosed with functional digestive disorders (FGIDs), usually present a complex clinical picture that poses a challenge for their management in primary care. The main objective of the current research was to examine the relationship of the congruence of the perception of severity and quality of life between gastroenterologists and their patients with psychological distress and the helping attitude experienced by the latter attended in primary care centres. Additionally, we wanted to explore patients’ and practitioners’ perceptions. We performed a cross-sectional study with a total of 2261 patients (1562 analysed) that attended three primary care centres. Patients completed questionnaires that measured physical functioning, distress, and perception of helping attitude. Gastroenterologists registered the functional status of each participating patient. Patients were then invited to take part in the qualitative part of the study if they were considered to have incongruent views on their functioning with their gastroenterologist. In total, 52 patients took part in one of eight focus groups. Additionally, four individual interviews were carried out with three gastroenterologists and one consultation-liaison psychiatrist specialised in FGIDs. Both incongruence and functional diagnosis correlated with distress. However, incongruent views between patients and gastroenterologists explained more variance. Statistically significant differences in patients’ helping attitude perception were detected between diagnostic but no incongruence groups. In the second stage of the study, a total of five themes were identified from the patient focus groups and the gastroenterologist interviews: illness-emotional and personal problems, disease-health system interaction, health system, intervention, and patients. The current research allowed us to confirm that incongruence in the perception of severity and quality of life between gastroenterologists and patients is related to psychological distress and that this occurs in a multifactorial context where the characteristics of the disorder interact with those of the health system.

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“…Nutrition and lifestyle medicine practitioners are only too aware of how psychosocial stress can affect gut function [ 60 , 114 , 115 ]. This stress normally manifests itself as changes in bowel motion regularity and/or stool consistency [ 116 , 117 ], most likely triggered by secondary changes in intestinal microbiota composition [ 118 , 119 ].…”

Section: The Microbiota-gut-brain Axis: a Complex Communication Symentioning

confidence: 99%

Harnessing the Power of Microbiome Assessment Tools as Part of Neuroprotective Nutrition and Lifestyle Medicine Interventions

Toribio-Mateas

2018

Microorganisms

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An extensive body of evidence documents the importance of the gut microbiome both in health and in a variety of human diseases. Cell and animal studies describing this relationship abound, whilst clinical studies exploring the associations between changes in gut microbiota and the corresponding metabolites with neurodegeneration in the human brain have only begun to emerge more recently. Further, the findings of such studies are often difficult to translate into simple clinical applications that result in measurable health outcomes. The purpose of this paper is to appraise the literature on a select set of faecal biomarkers from a clinician’s perspective. This practical review aims to examine key physiological processes that influence both gastrointestinal, as well as brain health, and to discuss how tools such as the characterisation of commensal bacteria, the identification of potential opportunistic, pathogenic and parasitic organisms and the quantification of gut microbiome biomarkers and metabolites can help inform clinical decisions of nutrition and lifestyle medicine practitioners.

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The role of incongruence between the perceived functioning by patients and clinicians in the detection of psychological distress among functional and motor digestive disorders

Cited by 4 publications

References 56 publications

Seated anorectal manometry during simulated evacuation: A physiologic exercise or a new clinically useful diagnostic test?

Seated anorectal manometry during simulated evacuation: A physiologic exercise or a new clinically useful diagnostic test?

Incongruent Views of Functioning between Patients and Gastroenterologists: A Mixed Methods Study

Harnessing the Power of Microbiome Assessment Tools as Part of Neuroprotective Nutrition and Lifestyle Medicine Interventions

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