Department of Paediatrics, University Hospitals Leuven, Leuven, Belgium.
BMJ Open. 2013 Dec 2;3(12):e003591. doi: 10.1136/bmjopen-2013-003591.
To describe (1) the content of a transition programme for young people with juvenile idiopathic arthritis (JIA) designed as a brief intervention, (2) the rationale and design of a mixed-methods study evaluating the clinical impact of this transition programme and (3) to provide baseline data of the intervention group.
An 'embedded experimental' design is used for the evaluation of the transition programme. A 'one-group pretest-posttest, with a non-equivalent posttest-only comparison group design' is used to quantitatively evaluate the impact of the transition programme, applying both longitudinal and comparative analyses. Subsequently, experiences of adolescents and their parents who participated in the experimental group will be analysed qualitatively using content analysis.
Participants in the intervention are recruited at a tertiary care centre in Belgium. The comparison group participants are recruited from one tertiary and three secondary care centres in Belgium.
The intervention group consists of 33 young people (25 females; 8 males) with a median age of 16 years. Main diagnoses are persistent or extended oligoarticular JIA (33%), polyarticular JIA (30%), enthesitis-related JIA (21%) or systemic arthritis (15%).
The transition programme comprises eight key components: (1) transition coordinator; (2) providing information and education; (3) availability by telephone; (4) information about and contact with an adult care programme; (5) guidance of parents; (6) meeting with peers; (7) transfer plan; and (8) actual transfer to adult care.
The primary outcome is health status, as perceived by the adolescents. Secondary outcomes are health status, as perceived by the parents; medication adherence; illness-related knowledge; quality of life; fatigue; promotion of independence; support of autonomy; behavioural control and psychological control.
At baseline, the median score was 69.2 (Q1=60.0;Q3=92.9) on psychosocial health and 68.8 (Q1=56.3; Q3=89.1) on physical health. Rheumatic-specific health scores ranged from 62.5 to 100.
We present the rationale and design of a study intended to evaluate a transition programme for adolescents with JIA as a brief intervention.
(1)描述为青少年特发性关节炎 (JIA) 患者设计的简短干预式过渡方案的内容;(2)评估该过渡方案的临床影响的混合方法研究的基本原理和设计;(3)提供干预组的基线数据。
采用“嵌入式实验”设计评估过渡方案。采用“单组前后测,后测无等效对照组设计”,对过渡方案的影响进行定量评估,同时进行纵向和比较分析。随后,采用内容分析法对参与实验组的青少年及其家长的经验进行定性分析。
比利时的一家三级护理中心招募参与干预的患者。比较组患者来自比利时的一家三级和三家二级护理中心招募。
干预组由 33 名年轻人组成(25 名女性;8 名男性),中位年龄为 16 岁。主要诊断为持续性或扩展寡关节炎型 JIA(33%)、多关节炎型 JIA(30%)、附着点相关关节炎(21%)或全身型关节炎(15%)。
过渡方案包括八个关键组成部分:(1)过渡协调员;(2)提供信息和教育;(3)通过电话提供帮助;(4)了解并与成人护理计划联系;(5)指导家长;(6)与同龄人会面;(7)转移计划;(8)实际转移到成人护理。
主要结果是青少年感知的健康状况。次要结果是父母感知的健康状况、药物依从性、疾病相关知识、生活质量、疲劳、促进独立性、支持自主性、行为控制和心理控制。
在基线时,心理社会健康的中位数评分为 69.2(Q1=60.0;Q3=92.9),身体健康的中位数评分为 68.8(Q1=56.3;Q3=89.1)。风湿特异性健康评分范围为 62.5 至 100。
我们介绍了一项旨在评估青少年特发性关节炎患者简短干预式过渡方案的研究的基本原理和设计。