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Published on: August 14, 2019
Paediatricians' perspectives in treating lower urinary tract symptoms: a qualitative exploratory needs assessment
Stav Spinzi1, Gunjan Agrawal1,2, Aditi Sharma1,3
1Department of Urology, Stanford University School of Medicine, Stanford, California, USA.
Insights
Pediatricians recognize pediatric lower urinary tract symptoms (LUTS) but face barriers like short visits and lack of guidelines. Improving care requires better education and screening strategies for children with LUTS.
Area of Science:
- Pediatric healthcare
- Urology
- Public health
Background:
- Pediatric lower urinary tract symptoms (LUTS) affect up to 20% of school-aged children.
- Paediatricians are the primary point of contact for LUTS management but lack formal resources.
- Understanding paediatricians' perspectives is crucial for improving pediatric health outcomes.
Purpose of the Study:
- To explore paediatricians' knowledge, beliefs, and practice patterns regarding pediatric LUTS care.
- To identify perceived barriers and facilitators influencing the provision of LUTS care by paediatricians.
- To inform health promotion strategies aimed at enhancing pediatric LUTS management.
Main Methods:
- Qualitative study utilizing semistructured focus groups with paediatricians in California.
- Thematic analysis was conducted using both deductive and inductive approaches.
- Participant enrollment continued until thematic saturation was achieved.
Main Results:
- 15 paediatricians participated, with most practicing in general outpatient settings.
- Paediatricians acknowledged LUTS as a significant issue impacting children's well-being.
- Barriers included short visit durations, competing demands, lack of guidelines, parental mistrust, and inadequate education.
Conclusions:
- Paediatricians are willing to manage LUTS but face significant practice limitations.
- Future efforts should focus on developing clinical guidelines for pediatric LUTS.
- Enhancing clinician education and implementing early screening strategies are recommended for timely intervention.
Background:
Paediatric lower urinary tract symptoms (LUTS) are common experiences among school-aged children, with prevalence rates reaching as high as 20%. Paediatricians are often first-line stakeholders in providing treatment for these bothersome symptoms, yet there is no formal resource to support them with the treatment of LUTS. Evaluating paediatricians' experiences is an important step in informing health promotion efforts to improve health outcomes in children. This study aims to explore paediatricians' knowledge, beliefs, practice patterns, and perceived barriers and facilitators in providing LUTS care.
Methods:
In this qualitative study, we conducted semistructured focus groups of paediatricians within California. Focus groups were conducted via Zoom, and participants were enrolled until thematic saturation was reached. Participants were asked about their current practices, knowledge and beliefs, barriers and facilitators to care, training and education, and responsibility for behaviour and action. Thematic analysis was performed using deductive and inductive approaches; themes were mapped through an iterative, team-based process.
Results:
15 paediatricians, aged 30-69 years, with 13 (86.7%) women, were interviewed. Most (11, 73.3%) practised in general outpatient settings. Interviewed paediatricians recognised paediatric LUTS as a common problem that can significantly impact children's well-being. In practice, paediatricians did not actively screen for LUTS beyond the potty-training milestone due to short visit duration and competing healthcare demands. Lack of guidelines, parental mistrust and inadequate clinical education were barriers identified by paediatricians.
Conclusions:
Paediatricians expressed a willingness to help patients but indicated several limitations to providing adequate LUTS care. Future professional development work can emphasise guideline development, early screening strategies to support timely intervention and better education for clinicians.
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