Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital and Department of Occupational Science & Occupational Therapy, University of Toronto, Canada.
Disabil Health J. 2018 Jan;11(1):149-154. doi: 10.1016/j.dhjo.2017.03.018. Epub 2017 May 31.
Youth with disabilities are at risk of poor health outcomes as they transition to adult healthcare. Although space and place play an important role in accessing healthcare little is known about the spatial aspects of youth's transition from pediatric to adult healthcare.
To understand the spaces of well-being as youth with physical disabilities transition from pediatric to adult healthcare.
This study draws on a qualitative design involving 63 in-depth interviews with young adults (n = 22), parents (n = 17), and clinicians (n = 24) involved in preparing young adults for transition. All participants were recruited from a pediatric rehabilitation hospital within a metropolitan area of Ontario, Canada. Data were analyzed using an inductive content analysis approach that was informed by the spaces of well-being framework.
The results highlight that within the 'spaces of capability' those with more disability-related complications and/or those using a mobility device encountered challenges in their transition to adult care. The 'spaces of security' influencing youth's well-being during their transition included: temporary (in)security while they were away at college, and health (in)security. Most of the focus on youth's transition included 'integrative spaces', which can enhance or hinder their well-being. Such spaces included: spatial (dis)connections (distance to access care), embeddedness (family and community), physical access, and distance. Meanwhile, therapeutic spaces involved having spaces that youth were satisfied with and enhanced their well-being as they transitioned to adult care.
In applying the spaces of well-being framework, the findings showed that youth had varied experiences regarding spaces of capability, security, integrative, and therapeutic spaces.
残疾青年在向成人医疗保健过渡时，健康状况不佳的风险较高。尽管空间和场所对获得医疗保健起着重要作用，但人们对青年从儿科向成人医疗保健过渡的空间方面知之甚少。
了解身体残疾青年从儿科向成人医疗保健过渡时的福祉空间。
本研究采用定性设计，涉及 63 名深度访谈，受访者包括准备青年过渡的青年（n=22）、父母（n=17）和临床医生（n=24）。所有参与者均来自加拿大安大略省大都市区的一家儿科康复医院。使用基于福祉空间框架的归纳内容分析方法对数据进行分析。
结果突出表明，在“能力空间”中，那些与更多残疾相关并发症相关的人或使用移动设备的人在向成人护理过渡时遇到了挑战。影响青年过渡期间福祉的“安全空间”包括：他们上大学期间的临时（安全）/不安全，以及健康（安全）不安全。大多数关于青年过渡的重点都集中在“整合空间”上，这可以增强或阻碍他们的福祉。这些空间包括：空间（连接）（获得护理的距离）、嵌入性（家庭和社区）、物理访问和距离。同时，治疗空间涉及到青年满意并在过渡到成人护理时增强他们福祉的空间。
通过应用福祉空间框架，研究结果表明，青年在能力空间、安全空间、整合空间和治疗空间方面有着不同的体验。
