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继续前进:炎症性肠病青少年和年轻成人的过渡准备。

Moving On: Transition Readiness in Adolescents and Young Adults With IBD.

机构信息

Denver VA Medical Center, Eastern Colorado Health Care System, Denver, CO.

Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL.

出版信息

Inflamm Bowel Dis. 2018 Feb 15;24(3):482-489. doi: 10.1093/ibd/izx051.

Abstract

BACKGROUND

Inflammatory bowel diseases (IBD) often begins early in life. Adolescents and young adults (AYA) with IBD have to acquire behaviors that support self-care, effective healthcare decision-making, and self-advocacy to successfully transition from pediatric to adult health care. Despite the importance of this critical time period, limited empirical study of factors associated with transition readiness in AYA exists. This study aimed to describe transition readiness in a sample of AYA with IBD and identify associated modifiable and nonmodifiable factors.

METHODS

Seventy-five AYA (ages 16-20) and their parents participated. AYA and parents reported on demographics, patient-provider transition-related communication, and transition readiness. AYA self-reported on disease self-efficacy. Disease information was abstracted from the medical record.

RESULTS

Deficits in AYA responsibility were found in knowledge of insurance coverage, scheduling appointments, and ordering medication refills. Older AYA age, higher AYA disease-management self-efficacy, and increased patient-provider transition communication were each associated with higher overall transition readiness and AYA responsibility scores. Regression analyses revealed that older AYA age and increased patient-provider transition-related communication were the most salient predictors of AYA responsibility for disease management and overall transition readiness across parent and AYA reports.

CONCLUSIONS

AYA with IBD show deficits in responsibility for their disease management that have the potential to affect their self-management skills. Findings suggest provider communication is particularly important in promoting transition readiness. Additionally, it may be beneficial to wait to transition patients until they are older to allow them more time to master skills necessary to responsibly manage their own healthcare.

摘要

背景

炎症性肠病(IBD)通常在生命早期开始。患有 IBD 的青少年和年轻人(AYA)必须养成支持自我护理、有效医疗决策和自我倡导的行为,以便从儿科顺利过渡到成人保健。尽管这一关键时期非常重要,但目前对 AYA 过渡准备相关因素的实证研究有限。本研究旨在描述 IBD 青少年和年轻人样本中的过渡准备情况,并确定相关的可改变和不可改变因素。

方法

75 名 AYA(年龄 16-20 岁)及其父母参与了研究。AYA 和父母报告了人口统计学信息、与患者-提供者过渡相关的沟通以及过渡准备情况。AYA 自我报告疾病自我效能感。疾病信息从病历中提取。

结果

在保险覆盖范围、预约和订购药物续药方面,AYA 的知识存在缺陷。年龄较大的 AYA、较高的 AYA 疾病管理自我效能感以及增加的患者-提供者过渡沟通与更高的整体过渡准备和 AYA 责任得分相关。回归分析显示,年龄较大的 AYA 年龄和增加的患者-提供者过渡相关沟通是影响疾病管理和父母和 AYA 报告的整体过渡准备的最显著的 AYA 责任预测因素。

结论

患有 IBD 的 AYA 在疾病管理方面表现出责任缺陷,这有可能影响他们的自我管理技能。研究结果表明,提供者的沟通在促进过渡准备方面尤为重要。此外,等待患者年龄较大时再进行过渡可能会使他们有更多的时间掌握负责管理自己医疗保健所需的技能。

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