Olds Janet, Fitzpatrick Elizabeth M, Séguin Christiane, Moran Linda, Whittingham Joanne, Schramm David
Cochlear Implants Int. 2014 Jan;15(1):2-12. doi: 10.1179/1754762813Y.0000000038. Epub 2013 Nov 25.
Youth and young adults with cochlear implants are now transitioning from pediatric to adult services in increasing numbers. Research in other areas of health care has indicated that there is a gap in the transition from pediatric services for the young adult, and that it is important to obtain their perspectives to reduce disruption and improve care. Previous research has documented issues from the perspective of cochlear implant professionals. The objectives of this study were to examine current practices from the perspective of young adults and their families and to make recommendations for future practice.
Interviews were conducted with 11 individuals, including cochlear implant recipients and their parents. All patients were within 4 years of transition between pediatric and adult hospital services: four youths were pediatric patients, and two had been discharged to adult services. Qualitative research methodology was used to identify key themes.
All participants indicated that they had not anticipated a change to an adult hospital as part of their plan of care. Key themes from interviews were differences between pediatric and adult hospitals, challenges in establishing new relationships with professionals, specific concerns about new health care settings and procedures, and the need for youth to develop independent health-related skills in the context of parental involvement.
Themes identified through interviews with young people with cochlear implants and their parents were similar to research in other areas of health care, as well as to themes identified in focus groups with professionals providing cochlear implant services. There were some differences which highlight both needs in the provision of health care and opportunities for providers and patients to collaborate to provide improved service delivery.
越来越多接受人工耳蜗植入的青少年和青年正从儿科服务过渡到成人服务。医疗保健其他领域的研究表明,青少年从儿科服务向成人服务的过渡存在差距,听取他们的意见对于减少干扰和改善护理非常重要。以往的研究从人工耳蜗专业人员的角度记录了相关问题。本研究的目的是从青少年及其家庭的角度审视当前的做法,并为未来的实践提出建议。
对11个人进行了访谈,包括人工耳蜗植入接受者及其父母。所有患者都处于儿科和成人医院服务过渡的4年之内:4名青少年是儿科患者,2名已转至成人服务。采用定性研究方法确定关键主题。
所有参与者均表示,他们在护理计划中并未预料到会转到成人医院。访谈中的关键主题包括儿科医院和成人医院的差异、与专业人员建立新关系的挑战、对新的医疗环境和程序的具体担忧,以及青少年在父母参与的情况下培养独立健康相关技能的必要性。
通过对人工耳蜗植入青少年及其父母的访谈确定的主题,与医疗保健其他领域的研究以及为人工耳蜗植入服务的专业人员焦点小组确定的主题相似。存在一些差异,这些差异既凸显了医疗保健提供方面的需求,也为提供者和患者合作提供更好服务提供了机会。