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Integrative treatment approaches: family satisfaction with a multidisciplinary paediatric Abdominal Pain Clinic

TLDR
Integrative care approaches to the evaluation of paediatric abdominal pain appear well accepted by families, yielding high levels of satisfaction, and enhance receptivity to treatment recommendations.
Abstract
Objectives : To assess patient and family satisfaction with evaluation received through a multidisciplinary paediatric Abdominal Pain Clinic (APC) staffed by a paediatric gastroenterologist and a paediatric psychologist as compared to a traditional gastroenterology clinic (GI) staffed by a paediatric gastroenterologist only Methods : Two hundred and ninety-eight families (145 APC, 153 GI) with a child or adolescent aged 8-17 years seen for initial evaluation of a chronic abdominal pain completed an anonymous survey to assess understanding of the treatment recommendations made, intent to follow through with various treatment recommendations, and the overall level of satisfaction with the evaluation service provided Family perceptions of strengths and challenges of the APC evaluation process also were explored Results : APC families reported being prescribed adjunctive mental health and other therapies at significantly higher rates than GI families, while the rates of medication were comparable APC families also reported significantly greater receptivity to beginning the treatments prescribed and higher levels of overall satisfaction with the evaluation process The contribution of integrated medical and psychological perspectives frequently was identified as a strength of the APC evaluation process Challenges identified for the APC evaluation were few and focused on issues related to paperwork and scheduling issues Conclusions : Integrative care approaches to the evaluation of paediatric abdominal pain appear well accepted by families, yielding high levels of satisfaction, and enhance receptivity to treatment recommendations Integrative care starting at the time of first evaluation may be particularly well-tailored to enhance outcomes, reduce health care utilization, and yield financial savings within this population

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Relieving pain in america: a blueprint for transforming prevention, care, education, and research

TL;DR: The National Academy of Sciences through its Institute of Medicine (IOM) has produced a major scholarly assessment of pain in America as mentioned in this paper, which is a tremendous contribution to the evolving nec...
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Characteristics of highly impaired children with severe chronic pain: a 5-year retrospective study on 2249 pediatric pain patients

TL;DR: Children with chronic pain are a diagnostic and therapeutic challenge as they often have two or more different pain diagnoses, are prone to misuse of analgesics and are severely impaired, and are at increased risk for developmental stagnation.
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Relieving pain in America.

TL;DR: Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research presents the IOM study committee’s findings and recommendations.
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Pediatric pain management: the multidisciplinary approach

TL;DR: This review summarizes different multidisciplinary clinics, focusing specifically on intensive pediatric pain rehabilitation centers, offering a summary of the challenges faced by these programs and areas for future study.
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Cognitive-behavioral treatment of persistent functional somatic complaints and pediatric anxiety: an initial controlled trial.

TL;DR: The study supports the feasibility and preliminary efficacy of a cognitive‐behavioral intervention targeting co‐occurring physical distress and anxiety in youth presenting for medical treatment and indicates reductions in children's somatic discomfort and anxiety following intervention.
References
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Childhood Functional Gastrointestinal Disorders: Child/Adolescent

TL;DR: The Rome III child and adolescent criteria represent an evolution from Rome II and should prove useful for both clinicians and researchers dealing with childhood FGIDs.
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Patients' perceptions of medical explanations for somatisation disorders: qualitative analysis.

TL;DR: Patients with somatisation disorders feel satisfied and empowered by medical explanations that are tangible, exculpating, and involving, which could improve these patients' wellbeing and help to reduce the high demands they make on health services.
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Chronic Abdominal Pain In Children: a Technical Report of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

TL;DR: Although children with chronic abdominal pain and their parents are more often anxious or depressed, the presence of anxiety, depression, behavior problems or recent negative life events does not distinguish between functional and organic abdominal pain.
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Rethinking medicine : improving health outcomes with cost-effective psychosocial interventions

TL;DR: Clinical interventions can be brought into better alignment with the emerging evidence on shared psychosocial determinants of health by providing services that address psychossocial needs and improve adaptation to illness.
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Primary Care Referral of Children With Psychosocial Problems

TL;DR: Examining primary care provider referral patterns for patients with psychosocial problems and to understand the factors that influence whether a mental health referral is made found many families are not effectively engaged in mental health services, even after a referrals is made.
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