Fidder, A.R. (2013) Somatisch onvoldoende verklaarde lichamelijke klachten (SOLK) bij kinderen en adolescenten: een vroege multidisciplinaire aanpak. Het effect van de multidisciplinaire BredeBlikPoli bij de benadering van (onverklaarde) lichamelijke klachten bij kinderen en. thesis, Medicine.
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Abstract
Introduction: Medically unexplained physical symptoms (MUPS) are common in children and adolescents. To prevent these children from long and unnecessary courses at the paediatrician, Gelre Ziekenhuis Apeldoorn introduced the multidisciplinary ‘Breadth Clinic’ in 2010. Children with unclear complaints are seen here in succession by a paediatrician, a psychologist and a physiotherapist. After all the biopsychosocial factors are obtained, an individual treatment plan is established in a multidisciplinary meeting. Our hypotheses are that because of this, children will recover faster from their complaints, spend less time in the medical circuit and the paediatrician will need less unnecessary diagnostic tests. Objectives: To evaluate whether the Breadth Clinic leads to a more efficient and effective approach towards children and adolescents with physical (unexplained) complaints. Study design: Retrospective controlled cohort study Methods: 123 children (age 4-18) who visited the Breadth Clinic between 1 January 2010 and 31 December 2011 have been included. The control group existed of 86 children who visited the paediatrician in the regular policlinic with similar complaints in 2009. The number of children fully recovered, the time it took them to recover, the amount of visits and the number of additional diagnostic tests were obtained from the medical records and compared between these two groups. Results: In the ‘Breadth Clinic’-group (BC-group) there were significantly more girls compared to the control group (72% vs. 58%). In addition, the children in de BC-group were older (median age: 14 vs. 10 years). Fatigue, headache and stomach-ache were seen most frequently. There was no significant difference between the number of recoveries between the BC-group (18%) and the control group (13%) (p=.320) The time to recovery was also comparable (median of 5,0 vs. 4,0 months). Significantly more children in the BC-group were treated by the psychologist (BC: 43%, control: 15%) and/or the physiotherapist (BC: 35%, control: 14 %). The total amount of visits was therefore higher in the BC-group than in the control group (median of 8,0 vs. 4,0; p=.004). They also spend significantly more time in the hospital with their complaints (23,0 vs. 10,5 weeks). Finally there had been done more additional diagnostic tests in the BC-group, most notably the amount of extensive blood tests (125 vs. 53 requests; p=.004). Conclusion: In this study, the multidisciplinary Breadth Clinic does not show a more effective or efficient approach towards unexplained physical complaints in children. However, more children had been treated by the psychologist and the physiotherapist. It should be emphasized that these quantitative measures.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Karthaus, dr. A.J.M. |
| Supervisor name: | Zaag-Loonen, dr. H. van der and Oldenziel-Sondaar, drs. M. and Pot, drs. D.J. and Gelre Ziekenhuizen, Apeldoorn |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:47 |
| Last Modified: | 25 Jun 2020 10:47 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/869 |
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