Weissberg-Benchell Jill, Shapiro Jenna B
Pediatr Ann. 2017 May 1;46(5):e182-e187. doi: 10.3928/19382359-20170421-01.
This article reviews studies that developed interventions aimed at facilitating the transition process and/or the transfer of youth with chronic illness to adult programs during the past decade. Three key intervention approaches have been studied. Data assessing the impact of transition coordinators suggest that the most successful outcomes occur when coordinators meet with patients prior to the transfer of care, support them as they negotiate the adult programs, and facilitate appointment keeping. Data assessing the impact of transition clinics suggest that the key to positive outcomes is helping patients develop a trusting relationship with the adult providers before fully transferring their care to the adult clinic. Similar conclusions can be drawn for transition programs, where it appears that the opportunity to discuss and plan transition with a pediatric provider over time and to meet with both the pediatric and adult providers simultaneously are beneficial for facilitating successful transfer to adult care. Although aspects of these care processes appear promising for improving transition success, this review identifies areas that need further study. We argue that studies are needed that examine individual patient and family-focused interventions as well as looking at other potential interventions in the health care system. [Pediatr Ann. 2017;46(5):e182-e187.].
本文回顾了过去十年中开展的旨在促进患有慢性病的青少年向成人项目过渡过程和/或转诊的研究。研究了三种关键的干预方法。评估过渡协调员影响的数据表明，当协调员在护理交接前与患者会面，在患者与成人项目协商时提供支持，并协助患者按时就诊时，会取得最成功的结果。评估过渡诊所影响的数据表明，取得积极结果的关键在于在将患者的护理完全转移到成人诊所之前，帮助患者与成人医疗服务提供者建立信任关系。对于过渡项目也可得出类似结论，即随着时间的推移与儿科医疗服务提供者讨论并规划过渡以及同时与儿科和成人医疗服务提供者会面的机会，有利于促进向成人护理的成功过渡。尽管这些护理过程的各个方面对于提高过渡成功率似乎很有前景，但本综述确定了需要进一步研究的领域。我们认为需要开展研究，以检验以患者个体和家庭为重点的干预措施，以及审视医疗保健系统中的其他潜在干预措施。[《儿科年鉴》。2017年；46(5):e182 - e187。]
