van Staa AnneLoes, Sattoe Jane N T
Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands; Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands; Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands; Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, The Netherlands.
J Adolesc Health. 2014 Dec;55(6):796-803. doi: 10.1016/j.jadohealth.2014.06.008. Epub 2014 Aug 19.
Transition of care of adolescents with chronic conditions is a critical area for clinicians. Patient-reported outcomes may provide important information on the quality of services. This cohort study examines young adults' experiences and satisfaction with the transfer to adult care and explores associations with patient characteristics.
Follow-up of 518 young adults (18-25 years) with various chronic conditions who completed a Web-based survey in 2006 (response rate, 52%). Outcome measures were the 18-item On Your Own Feet Transfer Experiences Scale (α = .93) and satisfaction with the transfer process (visual analog scale). Associations with demographic and health care-related variables, health-related quality of life, and self-management were explored with stepwise multivariate modeling, using past (2006-T0) and current (2012-T1) variables.
Of the respondents, 315 (65%) had transferred, while 10% was still in pediatric care and 25% was not in treatment anymore. Twenty percent rated their transfer as unsatisfactory, 50% felt prepared at the time of transfer, and 24% had met their adult-centered provider in advance. Men were more positive about their experiences and rated satisfaction higher than did women. Patient-centeredness of the adult health-care provider was the most important determinant for experiences (β = .29). Higher self-efficacy at T1 was associated with more positive experiences but not with higher satisfaction. The latter was higher for those transferred within the same hospital (β = .28).
The On Your Own Feet Transfer Experiences Scale is a useful instrument to measure transfer experiences. The importance young adults attach to good relations with their new provider stresses the necessity of early involvement of and good collaboration with adult care.
慢性病青少年患者的护理过渡是临床医生关注的关键领域。患者报告的结果可能为服务质量提供重要信息。这项队列研究调查了年轻人向成人护理过渡的经历和满意度，并探讨了与患者特征的关联。
对518名患有各种慢性病的年轻人（18 - 25岁）进行随访，他们于2006年完成了一项基于网络的调查（回复率为52%）。结果测量指标为18项“独立自主过渡经历量表”（α = 0.93）以及对过渡过程的满意度（视觉模拟量表）。使用过去（2006 - T0）和当前（2012 - T1）的变量，通过逐步多变量建模探索与人口统计学和医疗保健相关变量、健康相关生活质量以及自我管理的关联。
在受访者中，315人（65%）已完成过渡，10%仍在接受儿科护理，25%不再接受治疗。20%的人认为他们的过渡不令人满意，50%的人在过渡时感到有所准备，24%的人提前见过以成人护理为中心的医护人员。男性对他们的经历更为积极，满意度评分高于女性。成人医疗保健提供者以患者为中心是经历的最重要决定因素（β = 0.29）。T1时较高的自我效能感与更积极的经历相关，但与更高的满意度无关。在同一家医院内完成过渡的人满意度更高（β = 0.28）。
“独立自主过渡经历量表”是衡量过渡经历的有用工具。年轻人对与新医护人员建立良好关系的重视强调了成人护理早期介入和良好协作的必要性。
