General practitioners' experiences with chronic abdominal symptoms and a faecal calprotectin guided referral strategy in children: A Dutch qualitative study

被引:0
作者
Ansems, Sophie M. [1 ]
Berger, Marjolein Y. [1 ]
van Tol, Donald G. [1 ,2 ]
Olthof, Marijke [1 ]
Holtman, Gea A. [1 ]
机构
[1] Univ Groningen, Univ Med Ctr Groningen, Dept Primary & Long Term Care, Groningen, Netherlands
[2] Univ Groningen, Fac Behav & Social Sci, Dept Sociol, Groningen, Netherlands
关键词
Children; faecal calprotectin; qualitative research; functional gastrointestinal disorders; general practitioners; primary care; INFLAMMATORY-BOWEL-DISEASE; PRIMARY-CARE; DIAGNOSIS; PAIN; UNCERTAINTY;
D O I
10.1080/13814788.2024.2432417
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
BackgroundGeneral practitioners (GPs) often struggle to distinguish functional gastrointestinal disorders (FGID) from organic disorders in children with chronic abdominal symptoms. A referral strategy guided by faecal calprotectin (FCal) testing may help.ObjectiveThis study explores GPs' experiences with these children and the strategy.MethodsGPs were sampled purposively to data saturation. Ultimately, we conducted one focus group session and 13 semi-structured interviews with 17 Dutch GPs who had been involved in a randomised controlled trial evaluating an FCal-testing strategy. The online focus group and interviews were recorded, transcribed verbatim, and subject to thematic content analysis.ResultsFour themes arose: diagnostic confidence, fear of missing something severe, reassurance and managing FGID in primary care. Although GPs typically felt confident during the diagnostic process, they did fear missing somatic or psychosocial conditions. They felt more diagnostically confident due to FCals clear indications, high diagnostic accuracy, and non-invasiveness. Reassurance was considered crucial in children with FGID, either by labelling symptoms, providing explanatory models, or offering medical interventions (e.g. FCal testing). When helping children with FGID proved too difficult, GPs referred to specialist care. Besides the integration of FCal during reassurance, the testing strategy did not help GPs manage children with FGID.ConclusionWhile the FCal-strategy improved diagnosis according to GPs, they found the primary challenge to be managing children with FGID. Nevertheless, they found the FCal-strategy beneficial, likely due to its integration into reassurance strategies. Further research focusing on enhancing communication and interventions for paediatric FGID in primary care is warranted.
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页数:9
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