Son, J. van (Jasper) (2012) De opbrengst van een multidisciplinaire behandeling van jonge kinderen met een voedingsprobleem: Een vergelijking tussen twee behandelmethoden. thesis, Medicine.
Full text available on request.Abstract
Introduction: Feeding problems in young children have a negative influence on medical and psychosocial development. In this study we evaluate and compare the outcome of two different multidisciplinairy treatments of feeding problems. The multidisciplinairy team of the “Isala Klinieken” treats feeding problems with a psychotherapeutical and logopedical intervention. At the UMCG the treatment is based on a nutritinal intervention and tube feeding can be part of this treatment. The aim of this study is to evaluate and compare the outcome of those two interventions. We also aim to prove a difference in tube feeding policy between both teams. We furthermore asses the satisfaction of parents with the treatment. Material and method: In this multicenter cohort study we collected data of children with a feeding problem, without an organic cause, who started treatment after January 2009 at the Isala Klinieken or UMCG and finished treatment before March 2012. The primary outcome was the diagnosis of a feeding problem according to the Wilson criteria after treatment was finished. Improvement of standard deviations of weight to lenght at the start and end of treatment and follow-up was compared. The current feeding behaviour was rated by parents of children on the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and satisfaction of treatment on the Client Satisfaction Questionnaire 8 (CSQ-8). A questionnaire with data and growth curves of 30 anonymous patients were submitted to both teams to asses a difference in tube feeding policy. Results: 53 patients were included. (Isala Klinieken, n=30; UMCG n=23) Follow-up data of (median) 26 months after the start of the treatment was collected for 33 patients. (Isala Klinieken n=18; UMCG n=15) At the UMCG 9 children were treated with tube feeding, none were treated with tube feeding at the “isala klinieken”. (p=<0,001) The submitted questionair showed aswell that the UMCG started tube feeding more often (p=0,028) During follow-up more than one third of the children was still diagnosed with a feeding disorder. This outcome was the same for both interventions. Weight to lenght at the beginning and the end of the treatment did not improve for the children treated in the Isala klinieken (p=0,390), but did for the UMCG (p=0,006) Scores on the BPFAS (p=0,769) and CSQ-8 (p=0,879) were the same for both interventions. Conclusion: Feeding problems in young children are difficult to treat. After an intensive treatment more than one third of the children are still diagnosed with an feeding problem. Both intervention have the same outcome. An nutritional intervention, of which tube feeding can be part of, archieved an improvement of nutritional status of children. An psychotherapeutical and logepedical intervention did not improve the nutritional status. Both interventions had an similair outcome on feeding behavior and coping of parents with this behavior and satisfaction of treatment.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Begeleider: and Bekhof, J. and Isala klinieken, Zwolle. and Afdeling: Kindergeneeskunde |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:06 |
| Last Modified: | 25 Jun 2020 11:06 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2625 |
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