Diagnosis journey for children with juvenile idiopathic arthritis: a qualitative study.

Paediatrics Qualitative research Rheumatology

Journal

Archives of disease in childhood
ISSN: 1468-2044
Titre abrégé: Arch Dis Child
Pays: England
ID NLM: 0372434

Informations de publication

Date de publication:
22 Aug 2024
Historique:
received: 22 05 2024
accepted: 03 08 2024
medline: 23 8 2024
pubmed: 23 8 2024
entrez: 22 8 2024
Statut: aheadofprint

Résumé

The objective is to explore the journey to diagnosis and referral pathway from the onset of symptoms to the initial assessments at paediatric rheumatology (PR) centres, based on the experience of children with juvenile idiopathic arthritis (JIA) and their parents. We conducted a qualitative study with semistructured interviews. Our qualitative and phenomenological procedure applied interpretative phenomenological analysis. 19 families of children diagnosed with JIA 4-24 months before the study began (22 parents, 12 children>11 years), across 4 PR centres. The results highlight the contrasting feelings of children and their parents on the referral pathway and interactions with primary care physicians (PCPs). Four superordinate themes emerged: (1) the journey undertaken by families from initially trivialising the first symptoms to a growing sense of urgency, (2) the perception gap between the families' growing disquiet and first medical interventions, (3) the lack of guidance from physicians prompting parents to initiate action and (4) the various elements of the care pathway that influenced the way the diagnosis was experienced and its impact. The psychosocial consequences of delayed diagnosis in JIA should not be underestimated, especially for adolescents. The views and experiences of children and their parents on the diagnostic journey should be implemented in training programmes and guidelines for PCPs. The development of online supports, integrating the latest medical knowledge with testimonials from families about their experiences, with a common language for physicians and the general population, can facilitate communication and empower families to navigate the healthcare system. NCT05696340.Cite Now.

Identifiants

pubmed: 39174297
pii: archdischild-2024-327426
doi: 10.1136/archdischild-2024-327426
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT05696340']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Aurelie Chausset (A)

CRECHE Unit INSERM-CIC 1405, Department of Pediatrics, CHU Clermont-Ferrand, Clermont-Ferrand, France achausset@chu-clermontferrand.fr.
Research on Healthcare Performance (RESHAPE), INSERM U1290, Claude Bernard Lyon 1 University, Lyon, France.

Caroline Freychet (C)

Department of Pediatric Rheumatology, Necker-Enfants Malades Hospital, Paris, France.

Anne Lohse (A)

Department of Rheumatology, Competence center FAI2R, Franche-Comte Hospital, Belfort, France.

Alexandre Belot (A)

Pediatric Nephrology and Rheumatology, HFME, Hospices Civils Lyon, Bron, France.
National Referee Center RAISE & INSERM U1111, Lyon University, Lyon, France.

Etienne Merlin (E)

CRECHE Unit INSERM-CIC 1405, Department of Pediatrics, CHU Clermont-Ferrand, Clermont-Ferrand, France.

Stephane Echaubard (S)

CRECHE Unit INSERM-CIC 1405, Department of Pediatrics, CHU Clermont-Ferrand, Clermont-Ferrand, France.

Anne-Marie Schott (AM)

Research on Healthcare Performance (RESHAPE), INSERM U1290, Claude Bernard Lyon 1 University, Lyon, France.

Jonathan Lachal (J)

University of Clermont Auvergne, Clermont-Ferrand, France.
UVSQ, Inserm, CESP, Team DevPsy, Paris-Saclay University, Villejuif, France.
Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU Clermont-Ferrand, Clermont-Ferrand, France.

Classifications MeSH