Journal of Pediatric Psychology, Vol. 28, No. 6, 2003, pp. 423-432
© 2003 Society of Pediatric Psychology
Inpatient Pediatric Consultation-Liaison: A Case-Controlled Study
1 University of Louisville School of Medicine, 2 Indiana University School of Medicine
All correspondence should be sent to Bryan D. Carter, Division of Child and Adolescent Psychiatry, University of Louisville School of Medicine, 200 East Chestnut Street, Louisville, Kentucky 40202. E-mail: bdcart01{at}louisville.edu.
Objective To conduct a prospective case-controlled study of pediatric inpatients referred for consultation in a tertiary care children's medical center. Method Referrals (n = 104) were matched with nonreferrals (n = 104) for age (4 to 18 years), gender, and illness type/severity and completed parent- and self-report (dependent on age) behavioral rating scales to assess for adjustment/functioning. Nurses completed in-hospital ratings of behavioral/adjustment difficulties. Goal attainment and satisfaction ratings were obtained from the referring physicians, parents/guardians, and the consultant. Results Referrals exhibited more behavior/adjustment/coping difficulties than nonreferrals by parent, nurse, and self report. Frequently employed interventions included coping-strategies intervention, cognitive and behavioral therapies, and case management. Referring physician and consultant ratings of goal attainment were high, as were physician ratings of satisfaction and parent/guardian ratings of overall helpfulness. Conclusions Pediatric inpatients referred by their physicians had significantly more internalizing and externalizing disturbances than their nonreferred hospitalized peers. Many of the behavioral and adjustment problems that lead to in-hospital consultation referral were evident in global behavior difficulties prior to hospitalization. Referring pediatricians, parents/guardians, and consultants rate the outcome as benefiting the patients via assisting in the overall management of their health concerns, coping, and adjustment.
Key words: pediatric consultation-liaison; children; coping; hospitalization.
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