Price C S, Corbett S, Lewis-Barned N, Morgan J, Oliver L E, Dovey-Pearce G
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Tyne and Wear, UK.
Child Care Health Dev. 2011 Nov;37(6):852-60. doi: 10.1111/j.1365-2214.2011.01241.x.
The prevalence of Type 1 diabetes is increasing with more children and adolescents being diagnosed with this chronic condition. There has been an increasing focus in recent years on the transition through adolescence and supporting young people who have chronic health conditions, with the recognition that young people are at risk of dropping out of healthcare services following transfer from paediatric to adult services. To date, there have been limited evaluations of transition models. The purpose of this study is to evaluate one such model in diabetes, the 'Transition Pathway' via interviews with young people who have experienced it first-hand. The results are discussed in terms of understanding the unique needs of adolescents with regard to psychosocial developmental theory, and what this means for healthcare providers of transition/adolescent services.
Semi-structured interviews were carried out with 11 young people, two of whom returned a year later for a second interview. Qualitative analysis of these interviews using a 'Framework' approach enabled the data to be sorted according to initial themes. Following this, further analysis enabled the identification of 'super-ordinate' or overall themes.
Six initial themes emerged from the data. These concerned the transition pathway process, the experience and organization of transfer, organization of services, information and education, the healthcare consultation and the need for services to be inclusive of all young people's needs. From these initial themes, two overall/super-ordinate themes were identified: the need for transition services to be developmentally appropriate and to be based around individual needs. The consultation experience was central to keeping young people engaged with adolescent healthcare services.
Several key elements of adolescent/transition healthcare services have been proposed, one of which is training for professionals delivering the service. This study suggests that communication skills form a vital component of such training.
1型糖尿病的患病率正在上升，越来越多的儿童和青少年被诊断出患有这种慢性病。近年来，人们越来越关注青少年时期的过渡以及为患有慢性健康问题的年轻人提供支持，因为人们认识到年轻人在从儿科服务转至成人服务后有退出医疗服务的风险。迄今为止，对过渡模式的评估有限。本研究的目的是通过对亲身经历过“过渡途径”这一糖尿病过渡模式的年轻人进行访谈，来评估该模式。将根据心理社会发展理论来讨论结果，以了解青少年的独特需求，以及这对过渡/青少年服务的医疗服务提供者意味着什么。
对11名年轻人进行了半结构化访谈，其中两人一年后返回进行了第二次访谈。使用“框架”方法对这些访谈进行定性分析，使数据能够根据初始主题进行分类。在此之后，进一步分析确定了“上级”或总体主题。
数据中出现了六个初始主题。这些主题涉及过渡途径过程、转诊的经历和组织、服务的组织、信息与教育、医疗咨询以及服务满足所有年轻人需求的必要性。从这些初始主题中，确定了两个总体/上级主题：过渡服务需要在发展上适当并基于个人需求。咨询体验对于让年轻人继续接受青少年医疗服务至关重要。
提出了青少年/过渡医疗服务的几个关键要素，其中之一是对提供该服务的专业人员进行培训。本研究表明，沟通技巧是此类培训的重要组成部分。
