BACKGROUND: Among adults with functional gastrointestinal disorders, psychological distress influences who consults a physician, but little is known about predictors of consultation when the patient is a child. OBJECTIVE: To determine the relative contributions of psychological symptoms of the mother, psychological symptoms of the child, severity of child abdominal pain, and family stress to consultation. DESIGN: Observational study. SETTING: Health maintenance organization. PARTICIPANTS: Two hundred seventy-five mothers of 334 children who had abdominal pain in the past 2 weeks, as per child self-report. MAIN OUTCOME MEASURES: Mothers completed questionnaires about themselves (Symptom Checklist 90-Revised) and their children (school absences, medication use, and the Child Behavior Checklist). Children completed the Pain Beliefs Questionnaire to assess perceived pain severity. RESULTS: Thirty-nine children had been taken to the clinic for abdominal pain symptoms at least once in the past 3 months (consulters), whereas 295 were nonconsulters. Logistic regression analyses revealed that both the child's self-report of perceived pain severity (P<.001) and maternal psychological symptoms (P = .006) predicted consultation. Although children who visited physicians had significantly more psychological symptoms, this was not a significant predictor of consultation after adjusting for maternal psychological symptoms. Family stress did not predict consultation. CONCLUSION: The decision to take a child to the clinic for abdominal pain is best predicted by maternal psychological distress and the child's perceived pain severity.
BACKGROUND: Among adults with functional gastrointestinal disorders, psychological distress influences who consults a physician, but little is known about predictors of consultation when the patient is a child. OBJECTIVE: To determine the relative contributions of psychological symptoms of the mother, psychological symptoms of the child, severity of childabdominal pain, and family stress to consultation. DESIGN: Observational study. SETTING: Health maintenance organization. PARTICIPANTS: Two hundred seventy-five mothers of 334 children who had abdominal pain in the past 2 weeks, as per child self-report. MAIN OUTCOME MEASURES: Mothers completed questionnaires about themselves (Symptom Checklist 90-Revised) and their children (school absences, medication use, and the Child Behavior Checklist). Children completed the Pain Beliefs Questionnaire to assess perceived pain severity. RESULTS: Thirty-nine children had been taken to the clinic for abdominal pain symptoms at least once in the past 3 months (consulters), whereas 295 were nonconsulters. Logistic regression analyses revealed that both the child's self-report of perceived pain severity (P<.001) and maternal psychological symptoms (P = .006) predicted consultation. Although children who visited physicians had significantly more psychological symptoms, this was not a significant predictor of consultation after adjusting for maternal psychological symptoms. Family stress did not predict consultation. CONCLUSION: The decision to take a child to the clinic for abdominal pain is best predicted by maternal psychological distress and the child's perceived pain severity.
Authors: Rona L Levy; Shelby L Langer; Lynn S Walker; Joan M Romano; Dennis L Christie; Nader Youssef; Melissa M DuPen; Andrew D Feld; Sheri A Ballard; Ericka M Welsh; Robert W Jeffery; Melissa Young; Melissa J Coffey; William E Whitehead Journal: Am J Gastroenterol Date: 2010-03-09 Impact factor: 10.864
Authors: Joshua D Lipsitz; Daphne T Hsu; Howard D Apfel; Zvi S Marans; Rubin S Cooper; Anne Marie Albano; Merav Gur Journal: J Pediatr Date: 2011-08-24 Impact factor: 4.406
Authors: Rona L Levy; Shelby L Langer; Lynn S Walker; Joan M Romano; Dennis L Christie; Nader Youssef; Melissa M DuPen; Sheri A Ballard; Jennifer Labus; Ericka Welsh; Lauren D Feld; William E Whitehead Journal: JAMA Pediatr Date: 2013-02 Impact factor: 16.193