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自我效能感和心理韧性是炎症性肠病青少年过渡准备分数的有效预测指标。

Self-efficacy and Resilience Are Useful Predictors of Transition Readiness Scores in Adolescents with Inflammatory Bowel Diseases.

作者信息

Carlsen Katrine, Haddad Nichola, Gordon Julia, Phan Becky Lin, Pittman Nanci, Benkov Keith, Dubinsky Marla C, Keefer Laurie

机构信息

*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.

出版信息

Inflamm Bowel Dis. 2017 Mar;23(3):341-346. doi: 10.1097/MIB.0000000000001038.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

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