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2008 | OriginalPaper | Hoofdstuk

Adenotonsillectomie bij kinderen: arts en ouders op één lijn?

Beschouwing

Auteurs : Birgit van Staaij, Emma van den Akker, Gerrit Jan Hordijk, Arno Hoes, Anne Schilder

Gepubliceerd in: Schatjes zijn het

Uitgeverij: Bohn Stafleu van Loghum

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Samenvatting

  • Tonsillectomie, al dan niet gecombineerd met adenotomie, is een van de vaakst uitgevoerde operaties bij kinderen. Artsen zijn het erover eens dat de ingreep bij kinderen met erg vaak recidiverende tonsillitiden en het obstructieve slaapapneusyndroom voldoende effectief is om hem te rechtvaardigen; in Nederland ondergaat echter slechts 35% van de geopereerde kinderen voor een van deze twee indicaties een adenotonsillectomie. Ons recente Nederlandse onderzoek toont aan dat een verwijzing voor chirurgie bij kinderen met relatief milde klachten van recidiverende keelontstekingen en/of adenotonsillaire hypertrofie over het algemeen niet geïndiceerd is. Echter, veel huisartsen en KNO-artsen zijn van mening dat adenotonsillectomie effectief is bij deze kinderen. Ouders hebben in het algemeen ook hoge verwachtingen van de effectiviteit van de ingreep. In dit artikel onderzoeken wij de potentiële invloed van deze adenotonsillectomietrial op de dagelijkse praktijk. De vraag is of onze trialresultaten deze verwachtingen zullen veranderen. Als de huisarts zich kan vinden in de resultaten van ons onderzoek en besluit deze toe te passen in zijn dagelijkse praktijkvoering, heeft hij enkele mogelijkheden om dit evidence-based beleid te ondersteunen. Zo kan hij gezondheidsvoorlichting geven, zelfredzaamheid bij de behandeling van bovensteluchtwegklachten stimuleren, gesprekstechnieken tijdens consulten gebruiken zoals ‘shared decision-making’, gebruikmaken van behandelingsrichtlijnen en andere behandelingsmogelijkheden aanbieden.
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Metagegevens
Titel
Adenotonsillectomie bij kinderen: arts en ouders op één lijn?
Auteurs
Birgit van Staaij
Emma van den Akker
Gerrit Jan Hordijk
Arno Hoes
Anne Schilder
Copyright
2008
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-313-6642-2_16