UNC Kidney Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Ren Fail. 2012;34(6):744-53. doi: 10.3109/0886022X.2012.678171. Epub 2012 May 14.
To describe the development of the University of North Carolina (UNC) TR(x)ANSITION Scale that measures the health-care transition and self-management skills by youth with chronic health conditions.
Item and scale development of the UNC TR(x)ANSITION Scale was informed by two theoretical models, available literature, and expert opinion interviews and feedback from youth with chronic conditions, their parents, and interdisciplinary collaboration. Through an iterative process, three versions of the scale were piloted on a total of 185 adolescents and emerging adults with different chronic illnesses. This clinically administered scale relies on a semi-structured interview format of the patient and does not rely solely on patient report, but is verified with information from the medical record to validate responses.
Following the item development and the three iterations of the scale, version 3 was examined in a more intensive fashion. The current version of the UNC TR(x)ANSITION Scale comprises 33 items scattered across the following 10 domains: Type of illness, Rx=medications, Adherence, Nutrition, Self-management, Informed-reproduction, Trade/school, Insurance, Ongoing support, and New health providers. It requires approximately 7-8 min to administer. With a sample of 128 adolescents and young adults, ranging in age from 12 to 20, inter-rater reliability was strong (r = 0.71) and item-total correlation scores were moderate to high. Content and construct validity were satisfactory, and the overall score was sensitive to advancing age. The univariate linear regression yielded a beta coefficient of 1.08 (p < 0.0001), indicating that the total score increased with advancing age. Specifically, there was about a one point increase in the total score for each year of age.
The UNC TR(x)ANSITION Scale is a disease-neutral tool that can be used in the clinical setting. Initial findings suggest that it is a reliable and valid tool that has the potential to measure health-care transition skill mastery and knowledge in a multidimensional fashion.
描述北卡罗来纳大学（UNC）TR(x)ANSITION 量表的开发，该量表通过患有慢性疾病的青年来衡量医疗过渡和自我管理技能。
UNC TR(x)ANSITION 量表的项目和量表发展受到两个理论模型、现有文献以及来自患有慢性疾病的青年、他们的父母以及跨学科合作的专家意见访谈和反馈的指导。通过迭代过程，该量表的前三个版本共在 185 名患有不同慢性疾病的青少年和成年早期患者中进行了试点。该临床管理量表依赖于患者的半结构化访谈格式，不仅依赖于患者报告，还依赖于病历信息来验证回复。
在项目开发和量表的三个迭代之后，对版本 3 进行了更深入的研究。目前版本的 UNC TR(x)ANSITION 量表由 33 个项目组成，分布在以下 10 个领域：疾病类型、Rx=药物、依从性、营养、自我管理、知情生殖、交易/学校、保险、持续支持和新的医疗提供者。它需要大约 7-8 分钟来管理。在 128 名年龄在 12 至 20 岁之间的青少年和年轻人样本中，评分者间信度较强（r = 0.71），项目-总分相关性适中至较高。内容和结构效度令人满意，总分对年龄增长敏感。单变量线性回归得出的β系数为 1.08（p < 0.0001），表明总分随年龄增长而增加。具体来说，年龄每增加一岁，总分增加约一分。
UNC TR(x)ANSITION 量表是一种中性疾病的工具，可在临床环境中使用。初步研究结果表明，它是一种可靠且有效的工具，具有以多维方式衡量医疗过渡技能掌握和知识的潜力。
