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从美国成人医疗服务提供者的角度看青少年到成年的艾滋病毒保健过渡。

Adolescent to Adult HIV Health Care Transition From the Perspective of Adult Providers in the United States.

机构信息

Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina.

Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York City, New York.

出版信息

J Adolesc Health. 2017 Oct;61(4):434-439. doi: 10.1016/j.jadohealth.2017.05.011. Epub 2017 Jul 25.


DOI:10.1016/j.jadohealth.2017.05.011
PMID:28754584
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5898429/
Abstract

PURPOSE: The HIV Care Continuum highlights the need for HIV-infected youth to be tested, linked, and maintained in lifelong care. Care engagement is important for HIV-infected youth in order for them to stay healthy, maintain a low viral load, and reduce further transmission. One point of potential interruption in the care continuum is during health care transition from adolescent- to adult-centered HIV care. HIV-related health care transition research focuses mainly on youth and on adolescent clinic providers; missing is adult clinic providers' perspectives. METHODS: We examined health care transition processes through semi-structured interviews with 28 adult clinic staff across Adolescent Trials Network sites. We also collected quantitative data related to clinical characteristics and transition-specific strategies. RESULTS: Overall, participants described health care transition as a "warm handoff" and a collaborative effort across adolescent and adult clinics. Emergent transition themes included adult clinical care culture (e.g., patient responsibility), strategies for connecting youth to adult care (e.g., adolescent clinic staff attending youth's first appointment at adult clinic), and approaches to evaluating transition outcomes (e.g., data sharing). Participants provided transition improvement recommendations (e.g., formalized protocols). CONCLUSIONS: Using evidence-based research and a quality improvement framework to inform comprehensive and streamlined transition protocols can help enhance the capacity of adult clinics to collaborate with adolescent clinics to provide coordinated and uninterrupted HIV-related care and to improve continuum of care outcomes.

摘要

目的:艾滋病毒护理连续统一体强调了需要对感染艾滋病毒的青年进行检测,并将其联系起来,使他们终生接受护理。为了使感染艾滋病毒的青年保持健康,保持低病毒载量并减少进一步传播,他们需要参与护理。护理连续统一体中的一个潜在中断点是从青少年为中心的艾滋病毒护理向成人为中心的艾滋病毒护理进行医疗过渡。与艾滋病毒相关的医疗过渡研究主要集中在青年和青少年诊所提供者上;而忽略了成人诊所提供者的观点。

方法:我们通过对 28 名跨青少年试验网络地点的成人诊所工作人员进行半结构化访谈,研究了医疗过渡过程。我们还收集了与临床特征和特定过渡策略相关的定量数据。

结果:总体而言,参与者将医疗过渡描述为“温暖交接”,是青少年和成人诊所之间的协作努力。出现的过渡主题包括成人临床护理文化(例如,患者责任),将青年与成人护理联系起来的策略(例如,青少年诊所工作人员参加青年在成人诊所的首次预约),以及评估过渡结果的方法(例如,数据共享)。参与者提供了过渡改进建议(例如,制定正式协议)。

结论:使用循证研究和质量改进框架为全面和简化的过渡协议提供信息,可以帮助增强成人诊所与青少年诊所合作提供协调和不间断的艾滋病毒相关护理的能力,并改善护理连续统一体的结果。

相似文献

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Adolescent to Adult HIV Health Care Transition From the Perspective of Adult Providers in the United States.

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[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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引用本文的文献

[1]
Transition to Adult Care for Young People Living with HIV.

Curr HIV/AIDS Rep. 2025-3-1

[2]
Perspectives on health care transition among U.S. parents of internationally adopted children living with HIV: A qualitative study.

Health Care Transit. 2023-7-14

[3]
Mixed Methods Evaluation of a Youth-Friendly Clinic for Young People Living with HIV Transitioning from Pediatric Care.

Trop Med Infect Dis. 2024-8-28

[4]
A qualitative analysis of self-management needs of adolescents and young adults living with perinatally acquired HIV in rural, southwestern Uganda.

PLOS Glob Public Health. 2024-3-18

[5]
Retention and Viral Suppression Among Adolescents Newly Initiating Antiretroviral Therapy in Adult HIV Care in Lima, Peru: A Retrospective Cohort Study.

J Adolesc Health. 2024-2

[6]
Viral load and sexually transmitted infection testing among youth with HIV in a southern United States clinic.

Int J STD AIDS. 2024-1

[7]
Nurses' and Doctors' Experiences of Transferring Adolescents or Young Adults With Long-Term Health Conditions From Pediatric to Adult Care: A Metasynthesis.

Glob Qual Nurs Res. 2023-8-7

[8]
Strategies to improve outcomes of youth experiencing healthcare transition from pediatric to adult HIV care in a large U.S. city.

Arch Public Health. 2023-3-31

[9]
A Digital Platform to Support HIV Case Management for Youth and Young Adults: Mixed Methods Feasibility Study.

JMIR Form Res. 2022-11-21

[10]
Challenges and Fears of Adolescents and Young Adults Living with HIV Facing Transition to Adult HIV Care.

AIDS Behav. 2023-4

本文引用的文献

[1]
Associates of Engagement in Adult-Oriented Follow-Up Care for Childhood Cancer Survivors.

J Adolesc Health. 2017-2

[2]
Components of Interventions That Improve Transitions to Adult Care for Adolescents With Type 1 Diabetes.

J Adolesc Health. 2017-2

[3]
Transitioning HIV-Positive Adolescents to Adult Care: Lessons Learned From Twelve Adolescent Medicine Clinics.

J Pediatr Nurs. 2016

[4]
Linkage to and retention in care following healthcare transition from pediatric to adult HIV care.

AIDS Care. 2016

[5]
Health Care Transition in Young Adults With Type 1 Diabetes: Perspectives of Adult Endocrinologists in the U.S.

Diabetes Care. 2016-2

[6]
Achieving 90-90-90 in paediatric HIV: adolescence as the touchstone for transition success.

J Int AIDS Soc. 2015-12-2

[7]
Uncharted Territory: Systematic Review of Providers' Roles, Understanding, and Views Pertaining to Health Care Transition.

J Pediatr Nurs. 2015

[8]
Transition of youth living with HIV from pediatric to adult-oriented healthcare: a review of the literature.

Future Virol. 2015

[9]
Healthcare system supports for young adult patients with pediatric onset chronic conditions: a qualitative study.

J Pediatr Nurs. 2015

[10]
The adolescent and young adult HIV cascade of care in the United States: exaggerated health disparities.

AIDS Patient Care STDS. 2014-3

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