儿童与父母炎症性肠病症状报告的一致性水平

IF 1.3 Q3 PEDIATRICS Pediatric Gastroenterology, Hepatology & Nutrition Pub Date : 2023-03-01 Epub Date: 2023-03-07 DOI:10.5223/pghn.2023.26.2.88
Angharad Vernon-Roberts, Emma Rouse, Nerissa L Bowcock, Daniel A Lemberg, Andrew S Day
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引用次数: 0

摘要

目的:患有炎症性肠病(IBD)的儿童经常接受临床评估,包括临床医生、父母和儿童之间的三阶段沟通。在这种遭遇中,父母传统上是孩子IBD信息的主要沟通者,包括主观症状报告。儿童及其父母对IBD症状的一致程度尚不清楚,本研究旨在检验这一因素。方法:这是一项针对IBD儿童和父母一方的横断面研究。一个经过验证的儿科IBD症状报告工具(IBDnow)使儿童及其父母能够对七项疼痛、健康和粪便指标进行评分,两人同时完成该工具。结果评估采用:个体一致性:每个二人组相同症状报告的比例(理想得分>0.7);类别一致性:队列IBDnow指标的相同报告百分比;评分者间信度:Gwet的AC1系数得分越高,表示信度越好(最大值=1);儿童平均年龄12.2岁(标准差[SD]2.9,范围6-16),诊断后平均时间2.8年(标准差3),54%为女性,73%患有克罗恩病。平均个体一致性水平为0.6,27%的二人组同意≥6/7 IBDnow指标。61%的二人组报告了类别一致性,20%的父母高估了孩子的症状,19%的父母低估了他们的症状。评分者间的可靠性从一般到良好不等。结论:这些结果应该提高临床医生对父母IBD症状报告可能引入偏见的认识。儿童应被视为症状报告的最重要来源,IBDnow等工具可用于加强沟通。
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Agreement Level of Inflammatory Bowel Disease Symptom Reports between Children and Their Parents.

Purpose: Children with inflammatory bowel disease (IBD) frequently undergo clinical assessments, involving triadic communication between clinician, parent, and child. During such encounters parents are traditionally the main communicator of information on their child's IBD, including subjective symptom reports. The level of agreement between children and their parents for IBD symptoms is poorly understood, and this study aimed to examine this factor.

Methods: This was a cross-sectional study among children with IBD, and one parent. A validated paediatric IBD symptom report tool (IBDnow) enabled children and their parent to rate seven pain, well-being, and stool metrics, with dyads completing the tool concurrently. Results were assessed using: Individual agreement: proportion of identical symptom reports by each dyad (ideal score >0.7); Category agreement: percentage of identical reports for IBDnow metrics for the cohort; Inter-rater reliability: Gwet's AC1 coefficient with higher scores indicating better reliability (maximum=1).

Results: Seventy-four parent/child dyads participated; child's mean age 12.2 years (standard deviation [SD] 2.9, range 6-16), mean time since diagnosis 2.8 years (SD 3), 54% female, 73% had Crohn's Disease. Mean individual agreement level was 0.6, with 27% of dyads agreeing on ≥6/7 IBDnow metrics. Category agreement was reported by 61% of dyads, 20% of parents overestimated, and 19% underestimated, their child's symptoms. Inter-rater reliability ranged from fair to good.

Conclusion: These results should improve clinician awareness of how IBD symptom reports from parents may introduce bias. Children should be considered the most important source of symptom reports, and tools such as IBDnow utilised to enhance communication.

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来源期刊
CiteScore
3.90
自引率
0.00%
发文量
43
期刊介绍: Pediatric Gastroenterology, Hepatology and Nutrition (Pediatr Gastroenterol Hepatol Nutr), an official journal of The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition, is issued bimonthly and published in English. The aim of Pediatr Gastroenterol Hepatol Nutr is to advance scientific knowledge and promote child healthcare by publishing high-quality empirical and theoretical studies and providing a recently updated knowledge to those practitioners and scholars in the field of pediatric gastroenterology, hepatology and nutrition. Pediatr Gastroenterol Hepatol Nutr publishes review articles, original articles, and case reports. All of the submitted papers are peer-reviewed. The journal covers basic and clinical researches on molecular and cellular biology, pathophysiology, epidemiology, diagnosis, and treatment of all aspects of pediatric gastrointestinal diseases and nutritional health problems.
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