Carlsen Katrine, Haddad Nichola, Gordon Julia, Phan Becky Lin, Pittman Nanci, Benkov Keith, Dubinsky Marla C, Keefer Laurie
*Division of Pediatric Gastroenterology and Hepatology, Susan and Leonard Feinstein IBD Center, Icahn School of Medicine at Mount Sinai, New York, New York; †Division of Pediatrics, Hvidovre Hospital, University of Copenhagen, Denmark; and ‡Division of Gastroenterology, Susan and Leonard Feinstein IBD Center, Icahn School of Medicine at Mount Sinai, New York, New York.
Inflamm Bowel Dis. 2017 Mar;23(3):341-346. doi: 10.1097/MIB.0000000000001038.
Adolescence is a vulnerable period for those afflicted with inflammatory bowel disease (IBD). There is limited knowledge of factors influencing transition readiness in this population. We sought to determine whether self-efficacy and resilience would be informative predictors of transition readiness independent of age.
Patients with IBD aged 16 to 23 years cared for in a pediatric setting were prospectively enrolled. On entry, patients filled out the Transition Readiness Assessment Questionnaire (TRAQ); IBD Self-Efficacy Scale-Adolescent (IBD-SES-A); and the Connor-Davidson Resilience Scale. Demographic data and disease-specific information were collected from the medical record and by the provider. General linear modeling and autocorrelation were performed to investigate predictors of transition readiness.
Eighty-seven patients (62 Crohn's disease and 25 ulcerative colitis) were included, with a median age of 19 years (interquartile range 1-3: 17-20; min-max: 16-23). After controlling for age, the IBD-SES-A predicted TRAQ [F(1) = 11.69, R = 0.16, P = 0.001], accounting for 16% of the variance. The Connor-Davidson Resilience Scale also independently predicted TRAQ score [F(1) = 6.45, R = 0.09, P = 0.01], accounting for 9% of the variance. The IBD-SES-A and Connor-Davidson Resilience Scale were significantly auto correlated (r = 0.044, P = 0.001); in the final predictive model, only IBD-SES-A was predictive of TRAQ [F(1) = 4.01, R = 0.12, P = 0.004]. None of the patients' demographic, disease, or socioeconomic parameters informed transition readiness once self-efficacy and resilience were considered.
This is the first study to identify a reliable predictor of transition readiness scores in adolescents with IBD that does not seem to be influenced by age.
青春期对于炎症性肠病（IBD）患者来说是一个脆弱时期。关于影响该人群过渡准备状态的因素，我们了解有限。我们试图确定自我效能感和心理韧性是否会成为独立于年龄之外的、能反映过渡准备状态的有效预测指标。
前瞻性纳入在儿科环境中接受治疗的16至23岁IBD患者。入组时，患者填写过渡准备状态评估问卷（TRAQ）、IBD青少年自我效能量表（IBD-SES-A）以及康纳-戴维森心理韧性量表。从病历和医护人员处收集人口统计学数据及疾病相关信息。采用一般线性模型和自相关分析来研究过渡准备状态的预测指标。
纳入87例患者（62例克罗恩病和25例溃疡性结肠炎），中位年龄19岁（四分位间距1-3：17-20；最小-最大：16-23）。在控制年龄因素后，IBD-SES-A可预测TRAQ [F(1)=11.69，R=0.16，P=0.001]，解释了16%的方差。康纳-戴维森心理韧性量表也能独立预测TRAQ得分[F(1)=6.45，R=0.09，P=0.01]，解释了9%的方差。IBD-SES-A与康纳-戴维森心理韧性量表存在显著自相关（r=0.044，P=0.001）；在最终预测模型中，只有IBD-SES-A可预测TRAQ [F(1)=4.01，R=0.12，P=0.004]。一旦考虑自我效能感和心理韧性，患者的人口统计学、疾病或社会经济参数均无法反映过渡准备状态。
这是第一项确定IBD青少年过渡准备状态得分可靠预测指标的研究，该指标似乎不受年龄影响。
Zotero 插件