Stephany Heidi A, Ching Christina B, Kaufman Melissa R, Squiers Amanda, Trusler Lisa, Clayton Douglass B, Thomas John C, Pope John C, Adams Mark C, Brock John W, Tanaka Stacy T
Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN.
Department of Urology, Vanderbilt University, Nashville, TN.
Urology. 2015 Apr;85(4):959-63. doi: 10.1016/j.urology.2014.12.019.
To assess the awareness and readiness of both spina bifida patients and parents regarding the transition process before transitioning, with a secondary aim that included identifying potential factors associated with successful transition.
All children aged ≥14 years requiring long-term care were prospectively enrolled. Questions designed by pediatric and adult urologists and an adolescent health specialist addressing the awareness of long-term follow-up and the desire to learn more about transitioning were administered by nursing staff at regularly scheduled clinic appointments. All spina bifida patients evaluated in the past 5 years were identified, and clinical factors associated with transitioning were compared. Statistical analysis using the Fisher exact test and the chi-square test were used to compare patients' and parents' responses and categorical variables between patients transitioned and those eligible. P <.05 was considered significant.
A total of 33 surveys were prospectively collected. Twenty-two percent of parents and 40% of patients said they never wanted to transition (P = .28). Parents had thought about transitioning more than the patients (88.9% and 40%, respectively; P = .002). Of the 97 patients eligible for transition, 34% had a transition plan. The only significant predictor of transitioning to adult care was a previous history of stones (P = .03).
Transitioning to adult urologic care is a necessity for many, and parents are significantly more aware of transitioning than the patient. Acknowledging and understanding the concerns of patients and families will help optimize the transition to adult urologic care.
在脊柱裂患者及其父母进入过渡期之前，评估他们对过渡过程的认知和准备情况，次要目的包括识别与成功过渡相关的潜在因素。
前瞻性纳入所有年龄≥14岁且需要长期护理的儿童。由儿科和成人泌尿科医生以及青少年健康专家设计的关于长期随访认知和了解更多过渡信息愿望的问题，由护理人员在定期门诊预约时进行询问。确定过去5年中评估的所有脊柱裂患者，并比较与过渡相关的临床因素。使用Fisher精确检验和卡方检验进行统计分析，以比较患者和父母的回答以及已过渡患者和符合条件患者之间的分类变量。P<0.05被认为具有统计学意义。
前瞻性收集了共33份调查问卷。22%的父母和40%的患者表示他们从未想过过渡（P = 0.28）。父母比患者更多地考虑过过渡（分别为88.9%和40%；P = 0.002）。在97名符合过渡条件的患者中，34%有过渡计划。向成人护理过渡的唯一显著预测因素是既往有结石病史（P = 0.03）。
对许多人来说，向成人泌尿科护理过渡是必要的，并且父母比患者更清楚过渡事宜。认识并理解患者和家庭的担忧将有助于优化向成人泌尿科护理的过渡。
