Qualitative study evaluating the expectations and experiences of Dutch parents of children with chronic gastrointestinal symptoms visiting their general practitioner

Abstract

ObjectivesChronic gastrointestinal symptoms are common among children and affect their daily activities and quality of life. The majority will be diagnosed with a functional gastrointestinal disorder. Effective reassurance and education are, therefore, key components of the physician’s management. Qualitative studies have shown how parents and children experience specialist paediatric care, yet less is known about general practitioners (GPs), who manage most cases in the Netherlands and have a more personal and enduring relationship with their patients. Therefore, this study evaluates the expectations and experiences of parents of children visiting a GP for chronic gastrointestinal symptoms.DesignWe conducted a qualitative interview study. Online interviews were audio and video recorded, transcribed verbatim and independently analysed by the first two authors. Data were collected and analysed concurrently until data saturation was reached. Using thematic analysis, we developed a conceptual framework reflecting respondent expectations and experiences. We performed a member check of the interview synopsis and the conceptual framework.SettingDutch primary care.ParticipantsWe purposively sampled participants from a randomised controlled trial evaluating the effectiveness of faecal calprotectin testing in children with chronic gastrointestinal complaints in primary care. Thirteen parents and two children participated.ResultsThree key themes emerged: disease burden, GP–patient relationship and reassurance. Often, the experienced disease burden and the pre-existing GP–patient relationship influenced expectations (eg, for further investigations or a sympathetic ear), and when a GP fulfilled these expectations, a trusting GP–patient relationship ensued that facilitated reassurance. We found that individual needs influenced these themes and their interrelationships.ConclusionInsights provided by this framework could help GPs managing children with chronic gastrointestinal symptoms in daily practice and may therewith improve the consultation experience for parents. Further research should evaluate whether this framework also holds true for children.Trial registration numberNL7690.

Management of children with non-acute abdominal pain and diarrhea in Dutch primary care: a retrospective cohort study based on a routine primary care database (AHON)

“…Other studies showed that children with chronic abdominal pain continue to have symptoms later in life [ 31 , 32 ], suffer from school absenteeism [ 12 ], anxiety [ 12 , 33 ] and depression [ 33 ]. Follow-up could help the GP to develop a good doctor-patient relationship [ 34 ] and offer effective continuity of care, two important principles required for the often long-term care of these children [ 35 ]. A recent Norwegian interview study confirmed that GPs find it important to build a good relationship with (parents of) children with FGID [ 36 ].…”