Radboud University Nijmegen Medical Centre, The Netherlands.
J Pediatr Urol. 2013 Aug;9(4):509-15. doi: 10.1016/j.jpurol.2012.05.007. Epub 2012 Jun 12.
Transfers to adult care can be problematic, resulting in postponement due to the protective nature of pediatric care and patient dependency. It is unknown whether these findings apply specifically to urology patients. Our department is taking part in a national general transition project. In this light, our aim was to investigate the specific needs of adolescent urologic patients, regarding their independence and transition.
80 patients, born in 1975-1998, with a chronic bladder condition received a questionnaire. They were divided into pre- and post-transfer groups. Parents (n = 7) of post-transfer patients formed a third group. Questionnaires were based on those used in the national transition study, supplemented with urological questions. Pre-transfer patients were asked about their level of independence, what subjects were discussed during consultations, and their expectations and wishes regarding transfer. Post-transfer patients and parents were asked for their opinions on the transfer process.
73% (n = 58) responded (55 pre-transfer and 3 post-transfer patients plus parents). It appeared that the confidence built-up with the pediatric urologist impeded the transfer. An adequate level of disease-related knowledge was reported. Relationships, sexuality and fertility were hardly talked about (respectively n = 17, 16 and 18). Parents played an important role, which patients appreciated, confirming their dependency. Despite the 49% (n = 27) who stated they can arrange their urological care themselves, 44% (n = 24) felt ill-prepared for transfer.
Although overall self-perceived knowledge is sufficient, the trust in and personal relationship with the pediatric urologist formed the greatest obstruction to successful transition. These findings have been used to improve support during transition by creating a transition protocol.
患者转入成人护理可能会出现问题，由于儿科护理的保护性质和患者的依赖性，可能会导致延迟转科。目前尚不清楚这些发现是否专门适用于泌尿科患者。我们科室正在参与一个全国性的普通过渡项目。有鉴于此，我们旨在研究青少年泌尿科患者在独立性和过渡方面的具体需求。
80 名患有慢性膀胱疾病的患者（出生于 1975-1998 年）收到了一份问卷。他们被分为转科前和转科后两组。转科后患者的 7 名家长（n=7）组成了第三组。问卷基于全国过渡研究中使用的问卷，并补充了泌尿科相关问题。转科前患者被问及他们的独立程度、咨询中讨论了哪些科目、以及他们对转科的期望和愿望。转科后患者和家长被问及他们对转科过程的看法。
73%（n=58）的患者做出了回应（55 名转科前患者和 3 名转科后患者加家长）。与儿科泌尿科医生建立的信任似乎阻碍了转科。报告显示他们具备足够的疾病相关知识。很少涉及人际关系、性和生育问题（分别为 n=17、16 和 18）。家长发挥了重要作用，这得到了患者的赞赏，也证实了他们的依赖性。尽管 49%（n=27）的患者表示他们可以自行安排泌尿科护理，但 44%（n=24）表示他们对转科准备不足。
尽管总体上自我感知的知识足够，但对儿科泌尿科医生的信任和个人关系是成功过渡的最大障碍。这些发现已被用于通过创建过渡方案来改善过渡期间的支持。
