University of Minnesota, School of Medicine, Minneapolis, MN, USA.
Pediatr Rheumatol Online J. 2012 Nov 14;10(1):36. doi: 10.1186/1546-0096-10-36.
To increase understanding of the healthcare transition (HCT) process for young people living with Juvenile Idopathic Arthritis (JIA) by examining: 1) the extent to which youth report discussing HCT topics with their rheumatologist and 2) the association between youth perceptions of autonomy support from their rheumatologist and HCT discussions.
Data are from an online survey of youth in the United States with rheumatologic conditions (n= 134). HCT discussion was measured by 4 questions from the National Survey of Children with Special Health Care Needs. Youth perception of autonomy support was measured using a validated 6-item scale.
One third of the youth (33.7%) reported talking to their rheumatologist about transferring to adult medicine. Less than half (40.8%) of respondents talked with their rheumatologist about adult healthcare needs, and less than a quarter (22.0%) discussed acquiring health insurance as an adult. Nearly two-thirds of respondents (62.7%) reported that their rheumatologist usually/always encourages self-care responsibility. Multivariate analyses revealed significant associations between rheumatologist support for youth autonomy and HCT counseling.
The low frequency of HCT counseling reported indicates a continuing need to increase awareness among rheumatologist in the USA. The strong associations between rheumatologist's support for youth autonomy and HCT counseling suggest that developmentally "in-tune" providers may deliver the best guidance about transition planning for youth living with arthritis.
通过考察以下两点，增进人们对青少年特发性关节炎（JIA）患者医疗过渡（HCT）过程的理解：1）青少年与风湿病专家讨论 HCT 话题的程度；2）青少年感知到的来自风湿病专家的自主支持与 HCT 讨论之间的关联。
该数据来自于美国有风湿性疾病的青少年（n=134）的在线调查。HCT 讨论通过《特殊需要儿童国家调查》中的 4 个问题来衡量。青少年感知到的自主支持采用经过验证的 6 项量表来衡量。
三分之一的青少年（33.7%）表示曾与风湿病专家讨论过将其转到成人医学。不到一半（40.8%）的受访者与他们的风湿病专家讨论过成人医疗保健需求，不到四分之一（22.0%）讨论过作为成年人获得健康保险。近三分之二的受访者（62.7%）报告说他们的风湿病专家通常/总是鼓励他们自我护理。多变量分析显示，风湿病专家对青少年自主性的支持与 HCT 咨询之间存在显著关联。
报告的 HCT 咨询频率较低表明美国需要继续提高风湿病专家的意识。风湿病专家对青少年自主性的支持与 HCT 咨询之间的强烈关联表明，发展上“合拍”的提供者可能会为患有关节炎的青少年提供关于过渡计划的最佳指导。
