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Adjudication committee
- First opponent: Førsteamanuensis Merethe Kristine Andersen, Syd-dansk universitet, Odense
- Second opponent: Professor Siv Kvernmo, UiT Norges Arktiske Universitet
- Third member and chair of the evaluation committee: Professor Reidar Tyssen, University of Oslo
Chair of the Defence
Professor emeritus, Ole Rikard Haavet, Universitetet i Oslo
Summary
Anne Brodwall's study; "Children and adolescents with functional gastrointestinal disorders" emphasizes the complexity of the pain condition "functional gastrointestinal disorders" (FGIDs) in children and adolescents. The study wanted to explore more about the children's, adolescents', their families' and also the GPs' experiences of and reflections on FGIDs. In 2016 and 2019 interview studies were conducted with parents of children and adolescents (6-13,5 years old in 2016) who had been referred to the pediatric department, Drammen Hospital, with FGIDs. The focus was on the parents'/families' experiences of having a child/an adolescent with FGIDs. In 2020, the children and adolescents themselves were interviewed to hear their own words about what they thought could be the cause of the symptoms, how the disorders had affected them and their family and, not least, what had possibly helped them to get better. Later in 2020, an interview study was conducted with GPs in the region of the same hospital regarding children and adolescents with FGIDs.
The parents believed in both 2016 and 2019 that the symptoms mainly had a physical cause. However, some thought that difficulties at school or with friends could have influence on the child/adolescent. They were concerned that their child/adolescent should receive a diagnosis other than FGIDs as well as effective treatment. They wanted more information about the condition and closer contact with a doctor about the situation.The children and adolescents seemed to express more concerns than their parents about the fact that the FGIDs were related to non-physiological factors or even to mental stress. The adolescents reported that the symptoms made them feel sad, depressed and isolated from friends and social activities. The GPs pointed out that these young patients belong in the primary healthcare service and should not be referred to hospital and specialists. Despite this, 568 children and adolescents with FGIDs were referred from the GPs to the pediatric department in 2015.
Communication between doctor, patient and parents did not seem to provide the explanation and reassurance that the patients and parents called for. The symptoms seemed to be intensified by the anxiety and worry that the patient and the parents had about a serious disease that had not yet been releaved.
The focus for the young patients and their families should rather be on normality and coping with everyday life. Doctors must treat based on the biopsychosocial model. The model emphasizes that the problem has a biological, a psychological and a social side.
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