Abstract
Objective: The adult INTERMED is used to determine case complexity and psychosocial needs. We developed and validated a pediatric version of the INTERMED for children and adolescents with inflammatory bowel disease (IBD) and assessed its utility in predicting healthcare utilization. Methods: We performed a cross-sectional study of children (aged 8–17 y) with IBD (n = 148) and their parents, seen in a hospital-based clinic. Subjects completed semi-structured interviews that were scored on the 34 pIBD-INTERMED items. To assess inter-rater reliability, 40 interviews were videotaped and scored by a second assessor. Convergent and predictive validity were assessed by examining the relation of the pIBD-INTERMED to standardized measures of psychological, social, and family functioning, disease activity, and healthcare utilization. Results: Correlational analyses supported the validity of all five pIBD-INTERMED domains with very good inter-rater reliability (median r = 0.87) and internal consistency (α = 0.91) for the total complexity index. Ratings of 2–3 on the pIBD-INTERMED “mental health/cognitive threat” item were associated with greater odds of behavior and social problems (CBCL-Internalizing scale OR = 7.27, 95% CI 2.17–24.36); CBCL-Externalizing scale OR = 24.79, 95% CI 5.00–122.84), depression (Children's Depression Inventory OR = 8.52, 95% CI 1.70–43.02) and anxiety (Multidimensional Anxiety for Children OR = 11.57, 95% CI 3.00–45.37). The pIBD-INTERMED complexity index added significantly to the prediction of healthcare utilization, beyond the contribution of disease severity. Conclusions: The pIBD-INTERMED is a reliable and valid tool for identifying psychosocial risks and needs of children with IBD. It can be used to guide planning of individualized care and enhance interdisciplinary pediatric IBD care.
Original language | English |
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Pages (from-to) | 26-33 |
Number of pages | 8 |
Journal | Journal of Psychosomatic Research |
Volume | 119 |
DOIs | |
State | Published - Apr 2019 |
Bibliographical note
Funding Information:All authors have completed the Unified Competing Interest form at http://www.icmje.org/coi_disclosure.pdf and declare that (1) JC received partial support from Janssen Canada Inc., for the submitted work; (2) JSL, EI, CG and DRM have no competing interests to report. NC has previously received funding from Abbvie. The funders had no role in the study design, collection, analysis, and interpretation of data, preparation of the manuscript, or in the decision to submit the manuscript for publication.
Funding Information:
The authors wish to thank R. Singleton, A. Mack, L. Lenz, S. Hazel, L. Smith, S. Pira, and H. Rath-Wilson and J. Seymour for their contributions to the completion of this study. A Career Development Award from the Canadian Child Health Clinician Scientist Program , Canada and a New Investigator Award from the Canadian Institutes of Health Research , Canadian Association of Gastroenterology , and Crohn's and Colitis Canada supported EIB , Canada. Writing assistance was provided by Pauline Lavigne. This work was support by grants received from the IBD Foundation , Ontario Ministry of Health and Long-Term Care Academic Health Sciences Centres Alternate Funding Plan Innovation Fund, Canada, Children's Hospital of Eastern Ontario (CHEO), CHEO Research Institute , Canada, an investigator-initiated grant from Janssen Inc. , Canada and the Division of Gastroenterology, Hepatology & Nutrition, CHEO.
Funding Information:
The authors wish to thank R. Singleton, A. Mack, L. Lenz, S. Hazel, L. Smith, S. Pira, and H. Rath-Wilson and J. Seymour for their contributions to the completion of this study. A Career Development Award from the Canadian Child Health Clinician Scientist Program, Canada and a New Investigator Award from the Canadian Institutes of Health Research, Canadian Association of Gastroenterology, and Crohn's and Colitis Canada supported EIB, Canada. Writing assistance was provided by Pauline Lavigne. This work was support by grants received from the IBD Foundation, Ontario Ministry of Health and Long-Term Care Academic Health Sciences Centres Alternate Funding Plan Innovation Fund, Canada, Children's Hospital of Eastern Ontario (CHEO), CHEO Research Institute, Canada, an investigator-initiated grant from Janssen Inc., Canada and the Division of Gastroenterology, Hepatology & Nutrition, CHEO.
Publisher Copyright:
© 2019
Keywords
- Biopsychosocial screening
- Children
- Crohn's disease
- Inflammatory bowel disease
- Integrated care
- Ulcerative colitis
ASJC Scopus subject areas
- Clinical Psychology
- Psychiatry and Mental health