Lochridge Jillien, Wolff Joshua, Oliva Melisa, O'Sullivan-Oliveira Joanne
Inpatient Cardiology, Children's Hospital Boston, Boston, MA, USA.
Pediatr Nurs. 2013 Mar-Apr;39(2):81-9.
Negative outcomes are consistently reported when adolescent solid organ transplant recipients are transitioned to adult transplant programs. The purpose of this quality improvement project was to understand the perceptions of patients and their parents about self-care management at transition. Solid organ transplant recipients, 16 to 22 years of age (n = 10), in a 396-bed pediatric hospital in the northeastern United States and their parents (n = 10) completed semi-structured interviews regarding health, transplant history, and participants' thoughts and feelings related to transitioning to adult transplant centers. Qualitative data were analyzed using the phenomenological method with NVIVO software to identify themes across interviews. Themes included negative perceptions of adult transplant centers due to anxiety regarding the competencies of new providers in caring for the child's medical needs, unfamiliarity with adult medical providers, fear of letting go and assuming greater responsibility, and discrepancies between providers, parents, and patients. Clinical implications are discussed, including the creation of a pediatric transition clinic and strategies for providers to promote self-care management among patients.
当青少年实体器官移植受者过渡到成人移植项目时，负面结果屡有报道。本质量改进项目的目的是了解患者及其父母对过渡阶段自我护理管理的看法。在美国东北部一家拥有396张床位的儿科医院中，16至22岁的实体器官移植受者（n = 10）及其父母（n = 10）就健康状况、移植史以及参与者对过渡到成人移植中心的想法和感受完成了半结构化访谈。使用现象学方法和NVIVO软件对定性数据进行分析，以确定访谈中的主题。主题包括对成人移植中心的负面看法，原因是担心新提供者照顾孩子医疗需求的能力、对成人医疗提供者不熟悉、害怕放手和承担更大责任，以及提供者、父母和患者之间的差异。文中讨论了临床意义，包括设立儿科过渡诊所和提供者促进患者自我护理管理的策略。
