Beal Sarah J, Riddle Ilka K, Kichler Jessica C, Duncan Amie, Houchen Andrea, Casnellie Lori, Woodward Jason, Corathers Sarah D
Cincinnati Children's Hospital Medical Center and the Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
Cincinnati Children's Hospital Medical Center and the Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
Acad Pediatr. 2016 Sep-Oct;16(7):660-7. doi: 10.1016/j.acap.2016.06.007. Epub 2016 Jun 23.
Identifying differences in transition readiness according to chronic condition is essential for understanding whether special emphasis within specific populations is warranted. Youth with chronic conditions (type 1 diabetes, Turner syndrome, spina bifida, autism spectrum disorder [ASD]) representing various types of impairments were compared with youth without chronic conditions. It was hypothesized that differences would be observed according to condition type, with youth with cognitive/behavioral conditions showing less readiness than youth with other conditions and youth without chronic conditions showing the highest levels of transition readiness.
Patients (N = 163) ages 12 to 22 were recruited via outpatient clinics at a large freestanding children's hospital. Demographic characteristics (age, sex, race, and maternal education), health literacy, perceptions about health care responsibility, importance and confidence about transfer to adult health care, and the Transition Readiness Assessment Questionnaire (TRAQ) were included.
Significant differences in transition readiness were found according to condition type; youth with ASD had the lowest transition readiness scores. Patient and family characteristics and condition were predictors of TRAQ scores and self-perceived readiness to take responsibility for health care and transfer to adult care. Item-level analysis indicated that medication, appointment-keeping, and activities of daily living accounted for differences in TRAQ scores according to condition.
Disparities in transition readiness were detected across condition types, with potentially modifiable mechanisms identified to address gaps in readiness for youth transferring to adult health care systems. Developing interventions that assist providers in addressing these modifiable characteristics might improve transition to adult health care for adolescents with various chronic conditions.
根据慢性病情况识别过渡准备度的差异，对于理解特定人群是否需要特别关注至关重要。将患有各种类型损伤的慢性病青年（1型糖尿病、特纳综合征、脊柱裂、自闭症谱系障碍[ASD]）与无慢性病青年进行比较。研究假设是，根据疾病类型会观察到差异，认知/行为疾病青年的准备度低于其他疾病青年，而无慢性病青年的过渡准备度最高。
通过一家大型独立儿童医院的门诊招募了12至22岁的患者（N = 163）。纳入了人口统计学特征（年龄、性别、种族和母亲教育程度）、健康素养、对医疗保健责任的认知、对转至成人医疗保健的重要性和信心，以及过渡准备度评估问卷（TRAQ）。
根据疾病类型发现过渡准备度存在显著差异；患有ASD的青年过渡准备度得分最低。患者和家庭特征及疾病是TRAQ得分以及自我感知的对医疗保健负责和转至成人护理准备度的预测因素。项目层面分析表明，药物治疗、预约就诊和日常生活活动解释了TRAQ得分因疾病类型而异的情况。
在不同疾病类型中检测到过渡准备度的差异，并确定了可能可改变的机制来解决青年转至成人医疗保健系统准备度方面的差距。制定有助于医疗服务提供者解决这些可改变特征的干预措施，可能会改善患有各种慢性病的青少年向成人医疗保健的过渡。
