Shaw K L, Watanabe A, Rankin E, McDonagh J E
School of Health and Population Sciences (Nursing and Physiotherapy), University of Birmingham, Birmingham, UK.
Child Care Health Dev. 2014 Sep;40(5):663-70. doi: 10.1111/cch.12110. Epub 2013 Oct 21.
To examine the quality of transitional care in a paediatric and adult hospital by investigating (i) adherence to national transition guidance and (ii) whether implementation is associated with better patient/carer experiences.
A cross-sectional study was conducted in a UK paediatric hospital (PH) and neighbouring adult hospital. Clinics completed a questionnaire to determine characteristics of their transitional care provision and invited patients aged 11-21 years and parents/carers to complete a questionnaire ('Mind the Gap') to assess their satisfaction.
Twenty-three clinics participated. Fourteen (70%) reported delivering a transition programme, but only 5 (25%) indicated this was holistic (addressing medical, psychosocial and vocational issues). Participants included 457 young people and 330 parents, 71% and 88% respectively attending the PH. Ratings of current care were significantly lower than ratings of best care. These 'gap' scores were not excessive, although some participants were very dissatisfied. Better satisfaction was associated with attending clinics that provided transitional care, especially when defined as 'holistic' and youth-friendly.
Transition programmes that adhere to current guidance are associated with better satisfaction, but variations in provision suggest barriers to implementation. Attention is required to how youth-friendly transitional care is defined with particular reference to the specific clinic model.
通过调查（i）对国家转诊指南的遵循情况以及（ii）实施情况是否与更好的患者/护理人员体验相关，来评估一家儿科医院和一家成人医院的转诊护理质量。
在英国一家儿科医院（PH）和邻近的成人医院开展了一项横断面研究。各诊所填写了一份问卷，以确定其转诊护理服务的特点，并邀请11至21岁的患者及其父母/护理人员填写一份问卷（“注意差距”），以评估他们的满意度。
23家诊所参与了研究。14家（70%）报告开展了转诊计划，但只有5家（25%）表示该计划是全面的（涵盖医疗、心理社会和职业问题）。参与者包括457名年轻人和330名家长，分别有71%和88%的人在儿科医院就诊。对当前护理的评分显著低于对最佳护理的评分。这些“差距”分数并不过高，尽管一些参与者非常不满意。更好的满意度与就诊于提供转诊护理的诊所相关，尤其是当被定义为“全面的”和对年轻人友好时。
遵循当前指南的转诊计划与更高的满意度相关，但服务提供方面的差异表明存在实施障碍。需要关注如何定义对年轻人友好的转诊护理，特别是参考具体的诊所模式。
