University of Amsterdam, Amsterdam, the Netherlands.
Inflamm Bowel Dis. 2012 Dec;18(12):2310-4. doi: 10.1002/ibd.22937. Epub 2012 Feb 28.
Patients with chronic health needs are expected to gradually assume responsibility for health maintenance behavior as they move toward adulthood. We sought to evaluate the influence of factors such as age, duration of disease, and gender by examining the self-reported health behaviors of adolescents with inflammatory bowel disease (IBD).
Confidential voluntary surveys were administered to all IBD outpatients over age 10 during a 4-month period. Questions addressed responsibility for health behaviors such as medication, provider visits, and communication. Likert scales measured the degree of independence: 1 (my parents only) through 3 (parents share equally with me) to 5 (I do it myself). Patient participation during doctor visits was also assessed.
Of 358 patients approached, 294 (82%) returned completed surveys. Respondents were 51% male and 69% had Crohn's disease. Patients took increasingly active roles, but by ages 19-21 only 45% ordered medication refills, and 50% picked up medication from pharmacy. Only 35% of 19-21-year-olds scheduled appointments and 30% contacted providers between visits if problems arose. Most patients could answer provider questions (55% at age 16-18) but fewer asked questions of the provider (15% at the same age). Males were less likely to order their own prescription refills (P = 0.017) or prepare questions (P = 0.009). Duration of disease did not change skill acquisition.
Adolescents develop independence in managing their IBD slowly and many patients ≥ 18 years are still assisted by parents. Focus on specific skill acquisition may help patients with self-management skills expected in adult healthcare.
患有慢性健康需求的患者随着年龄的增长逐渐需要承担健康维护行为的责任。我们试图通过检查炎症性肠病 (IBD) 青少年的自我报告健康行为来评估年龄、疾病持续时间和性别等因素的影响。
在 4 个月的时间内，对所有 10 岁以上的 IBD 门诊患者进行了机密自愿调查。问题涉及到健康行为的责任，如药物、就诊和沟通。李克特量表衡量了独立性的程度：1（只有我的父母）到 3（父母与我平等分担）到 5（我自己做）。还评估了患者在就诊期间的参与度。
在 358 名接受调查的患者中，294 名（82%）返回了完整的调查。受访者中男性占 51%，69%患有克罗恩病。患者承担了越来越积极的角色，但到 19-21 岁时，只有 45%的人会订购药物续药，而 50%的人会从药房取药。只有 35%的 19-21 岁患者预约，并且如果出现问题，50%的患者会在就诊期间与提供者联系。大多数患者可以回答提供者的问题（16-18 岁时为 55%），但较少询问提供者的问题（同一年龄时为 15%）。男性更不可能自行订购处方药续药（P=0.017）或准备问题（P=0.009）。疾病持续时间并未改变技能的获取。
青少年在管理他们的 IBD 方面的独立性发展缓慢，许多≥18 岁的患者仍需要父母的帮助。关注特定技能的获取可能有助于患者掌握成年医疗保健所需的自我管理技能。
