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儿科炎症性肠病当前的过渡实践:一项针对儿科医疗服务提供者的全国性调查结果

Current Transition Practices in Pediatric IBD: Findings from a National Survey of Pediatric Providers.

作者信息

Gray Wendy N, Maddux Michele H

机构信息

*Department of Psychology, Auburn University, Auburn, Alabama; and †Division of Developmental and Behavioral Sciences and Division of Gastroenterology, Children's Mercy Kansas City, Kansas City, Missouri.

出版信息

Inflamm Bowel Dis. 2016 Feb;22(2):372-9. doi: 10.1097/MIB.0000000000000642.

Abstract

BACKGROUND

Although practice guidelines have been published for transition to adult care among general chronic illness populations and specific to pediatric inflammatory bowel disease (IBD), little is known about current transition practices in IBD care. This study presents data characterizing current transition practices as reported by a national sample of pediatric providers in the United States.

METHODS

One hundred forty-one pediatric providers completed an online survey designed to assess current transition practices, barriers and challenges to developing and maintaining transition programming, and desired resources to improve transition services.

RESULTS

Practices varied greatly in terms of when providers begin discussing transition and transfer, age at transfer to adult care, and patient supports provided to facilitate transition. Multiple disciplines were often involved in transition programming and 75.9% reported using objective assessment of patient transition readiness. Knowledge and application of published transition practice guidelines was limited, and few respondents reported having a written transition policy at their institution (14.2%). 99.3% of respondents reported barriers to their transition programming efforts. Additional time and instrumental supports were the most common desired resources to support transition efforts.

CONCLUSIONS

Variability in IBD transition programming, practices, and policies reflect the emerging nature of clinical practice in this area. Understanding the current state of transition programming can inform future programming. Efforts to identify evidence-based practices in transition to adult care are needed.

摘要

背景

尽管已经发布了针对一般慢性病群体向成人护理过渡以及特定于儿科炎症性肠病(IBD)的实践指南,但对于IBD护理中当前的过渡实践知之甚少。本研究展示了美国全国范围内儿科医疗服务提供者样本所报告的当前过渡实践特征数据。

方法

141名儿科医疗服务提供者完成了一项在线调查,该调查旨在评估当前的过渡实践、开展和维持过渡计划的障碍与挑战,以及改善过渡服务所需的资源。

结果

在医疗服务提供者开始讨论过渡和转诊的时间、转诊至成人护理的年龄以及为促进过渡而提供的患者支持方面,实践差异很大。多个学科通常参与过渡计划,75.9%的受访者报告使用了对患者过渡准备情况的客观评估。已发布的过渡实践指南的知识和应用有限,很少有受访者报告其所在机构有书面的过渡政策(14.2%)。99.3%的受访者报告了他们过渡计划工作面临的障碍。额外的时间和工具性支持是支持过渡工作最常见的所需资源。

结论

IBD过渡计划、实践和政策的差异反映了该领域临床实践的新兴性质。了解过渡计划的当前状态可为未来计划提供参考。需要努力确定向成人护理过渡的循证实践。

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