Fair Cynthia D, Sullivan Kristen, Gatto Amy
Human Service Studies, Elon University, NC, USA.
AIDS Care. 2011 Aug;23(8):965-70. doi: 10.1080/09540121.2010.542449. Epub 2011 Jun 28.
Rates of HIV infection among adolescents in the US continues to rise, resulting in more individuals who must eventually transition from pediatric to adult care. It is critical that this process go smoothly to ensure continuity of care and to maximize patient outcomes. While research has examined youths' experiences with the transition process, disease-specific indicators of successful transition from pediatric to adult care remain undefined. Identifying indicators will facilitate the evaluation of transition processes, and, ultimately, the empirical determination of best practices. Interviews were conducted with 19 professionals who provide care for children and adults with HIV in southeastern state in the US. Approximately half of the providers self-identified as pediatric care providers. Nine of those interviewed were nurses and physicians and 10 were social workers. Providers had been working in the field of HIV for an average of 11.2 years. Interviews were taped, transcribed, and coded for emergent themes. Providers who care for HIV-infected youth identified both behavior and seriologic indicators of succesful transitions. Behavioral indicators identified were keeping appointments, medication adherence, and demonstrating ownership of medical care. Providers also identified serological markers of a succesful transition, specifically,viral load and CD4 count. Findings provided valuable insight into the perspectives of infectious disease care providers on indicators of successful transition from pediatric to adult care for adolescents with HIV. This is an important first step in developing empirical evaluation measures for transition practices and models. Similar research should be conducted with other groups of providers to assess the generalizability of these findings. Additionally, future research should seek to operationalize the identified behavioral indicators and determine appropriate values to indicate success for all indicators.
美国青少年中的艾滋病毒感染率持续上升，导致更多个体最终必须从儿科护理过渡到成人护理。这一过程顺利进行对于确保护理的连续性以及最大化患者治疗效果至关重要。虽然已有研究考察了青少年在过渡过程中的经历，但从儿科护理成功过渡到成人护理的疾病特异性指标仍未明确。确定这些指标将有助于评估过渡过程，并最终通过实证确定最佳实践方法。研究人员对美国东南部一个州为感染艾滋病毒的儿童和成人提供护理的19名专业人员进行了访谈。大约一半的提供者自称是儿科护理提供者。其中9名受访者是护士和医生，10名是社会工作者。这些提供者在艾滋病毒领域的工作平均时长为11.2年。访谈进行了录音、转录，并针对出现的主题进行了编码。照顾感染艾滋病毒青少年的提供者确定了成功过渡的行为指标和血清学指标。确定的行为指标包括按时赴约、坚持服药以及表现出对医疗护理的自主意识。提供者还确定了成功过渡的血清学标志物，特别是病毒载量和CD4细胞计数。研究结果为传染病护理提供者对感染艾滋病毒青少年从儿科护理成功过渡到成人护理的指标的看法提供了宝贵的见解。这是为过渡实践和模式制定实证评估措施的重要第一步。应该与其他提供者群体进行类似研究，以评估这些结果的普遍性。此外，未来的研究应设法将确定的行为指标付诸实践，并确定所有指标表明成功的适当数值。
