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小儿肝移植受者向成人护理的过渡:患者及家长的观点

Transition of pediatric liver transplant recipients to adult care: patient and parent perspectives.

作者信息

Fredericks Emily M, Dore-Stites Dawn, Lopez M James, Well Andrew, Shieck Victoria, Freed Gary L, Eder Sally J, Magee John C

机构信息

Department of Pediatrics, University of Michigan Health System, Ann Arbor, MI 48109-5318, USA.

出版信息

Pediatr Transplant. 2011 Jun;15(4):414-24. doi: 10.1111/j.1399-3046.2011.01499.x. Epub 2011 Apr 26.

DOI:10.1111/j.1399-3046.2011.01499.x
PMID:21521433
Abstract

The need to prepare pediatric transplant recipients for the transfer to adult-centered transplant care has received increased attention. This study aimed to determine adolescent and young adult LTR and parent perceptions and attitudes about the transition process. LTR and their parents completed a survey assessing level of prior thought and interest in learning about transferring care, knowledge of the transition process, perceived importance of self-management skills, concerns about moving to the adult clinic, and responsibility for health management tasks. Responses were analyzed by age, gender, and time since transplantation. Participants included 46 LTR (mean age = 16.6 yr; range 12-21), and 31 parents. Recipients and parents reported moderate concern about transition, with leaving pediatric providers being a primary worry. LTR ≥16 yr reported greater health care responsibility and increased thought, interest, and knowledge about transition. There were significant differences between parent and LTR perceptions of health care responsibility, indicating that LTR perceive having more independence than what their parents report. Overall, results suggest that adolescent and young adult LTR and their parents perceive the importance of transitional care, but demonstrate poor knowledge of the process. There remains a need for improved transition planning for both adolescents and parents.

摘要

让儿科移植受者为向以成人为主的移植护理过渡做好准备的需求已受到越来越多的关注。本研究旨在确定青少年及年轻成人长期移植受者(LTR)及其父母对过渡过程的看法和态度。LTR及其父母完成了一项调查,评估他们之前对了解护理转移的思考程度和兴趣、对过渡过程的了解、对自我管理技能重要性的认知、对转到成人诊所的担忧以及对健康管理任务的责任。根据年龄、性别和移植后的时间对回答进行分析。参与者包括46名LTR(平均年龄 = 16.6岁;范围12 - 21岁)和31名父母。受者和父母表示对过渡适度担忧,其中离开儿科医疗服务提供者是主要担忧。16岁及以上的LTR报告称承担了更大的医疗保健责任,并且对过渡的思考、兴趣和了解有所增加。父母和LTR对医疗保健责任的认知存在显著差异,这表明LTR认为自己比父母所报告的更具独立性。总体而言,结果表明青少年及年轻成人LTR及其父母认识到过渡护理的重要性,但对该过程的了解较差。青少年和父母仍需要改进过渡计划。

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