Midway evaluation - Ragnhild Bentung Lygre
Midway evaluation for the PhD degree at the University of Bergen for candidate Ragnhild Bentung Lygre
Ragnhild Bentung Lygre is affiliated with the Department of Clinical Medicine. Supervisors are Irene Bircow Elgen, Rolf Gjestad, Helene Helgeland and Tone Merete Norekvål.
Evaluation of an interdisciplinary intervention for children with multiple referrals to specialist healthcare
Children with complex health complaints are often referred to several different healthcare specialists for assessments and treatment. This may result in fragmented care, higher risks of medical errors, and sub-optimal health outcomes. We need to know more about who these children are, what they suffer from and how we can improve healthcare for these patients.
Following the British Medical Research Council’s framework for developing and evaluating complex interventions, we have developed, piloted, evaluated, and implemented a new interdisciplinary intervention for children with complex health complaints and multiple referrals to specialist healthcare, the Transitioning Patient’s Trajectories (TpT)-intervention. The intervention consists of an interdisciplinary team (doctor, psychologist, physiotherapist) engaging the child and parents in a consultation aiming to clarify the child’s condition and making a joint treatment plan. The evaluation of the intervention is through a feasibility study collecting patient and parent experiences with the evaluation, and patient reported outcomes such as health-related quality of life, mental health complaints, demographic characteristics and functional level (school attendance). Outcome measures were completed at baseline and one year follow up.
Parents of children with complex health complaints and multiple referrals to specialist healthcare call for interventions targeting wait time, accommodation of consultations, communication regarding the following treatment and collaboration within specialist healthcare. Project developed criteria for identifying eligible patients for such interventions seemed feasible. Children and adolescents with complex health complaints and multiple referrals to specialized healthcare experience considerable functional impairment. The developed TpT-intervention appear highly acceptable with positively reported experiences from parents of, and children with, complex health complaints.
A future randomized controlled trial is both feasible and required to test the effectiveness of the TpT-intervention.