Insights in the use of health care services in chronic... : PAIN (original) (raw)

Article

Insights in the use of health care services in chronic benign pain in childhood and adolescence

Perquin, Christel W.a,*; Hunfeld, Joke A.M.a,b; Hazebroek-Kampschreur, Alice A.J.M.c; van Suijlekom-Smit, Lisette W.A.d; Passchier, Janb; Koes, Bart W.a; van der Wouden, Johannes C.a

a_Department of General Practice, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands_

b_Department of Medical Psychology & Psychotherapy, Netherlands Institute of Health Sciences, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands_

c_Municipal Health Service, P.O. Box 70032, 3000 LP, Rotterdam, The Netherlands_

d_Department of Pediatrics, Sophia Children's Hospital / University Hospital Rotterdam, P.O. Box 2060, 3000 CB, Rotterdam, the Netherlands_

*Corresponding author. Department of General Practice, (Room Ff 321), Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, the Netherlands. Tel.: +31-10-408-7621; fax: +31-10-408-9491

E-mail: [email protected]

Received 24 May 2000; received in revised form 19 April 2001; accepted 21 May 2001.

Abstract

The utilization of health care services in children and adolescents with chronic benign pain was studied in a Dutch population sample of 254 chronic pain sufferers aged 0–18 years. Children and adolescents who had reported chronic pain (continuous or recurrent pain >3 months) in our previous prevalence study were asked to keep a 3-week diary on their pain and to fill out questionnaires on background factors, health care use and the impact of pain. Parent ratings were used for children aged 0–11 years, self-report was used in adolescents (12–18 years). In a 3-month period, in 53.4% of the cases medication was used for pain, and general practitioners and specialists were consulted for pain in 31.1% and 13.9% of subjects, respectively. Physiotherapists, psychologists and alternative health providers were visited by 11.5, 2.8, and 4.0%, respectively. In the preceding year, 6.4% had been hospitalized due to pain. The most important factors linked to utilizing medical services were gender, various pain characteristics, school absenteeism and disability. Although consulters reported to be less physically fit and less satisfied with health, their parents were better adapted to the pain, by talking and sharing, mutual support, normalization of the child and heightened self-esteem, than non-consulters. Prospective studies are needed to test causality of coping on care-seeking behavior.