Gastroenterology, Cleveland Clinic, Cleveland, Ohio.
Clinical Assistant Professor of Pediatrics, Pediatric Gastroenterology, Cleveland Clinic, Cleveland, Ohio.
Inflamm Bowel Dis. 2019 Jan 1;25(1):45-55. doi: 10.1093/ibd/izy207.
Transitional care for patients with IBD focuses on efforts to successfully transfer care from pediatric to adult providers while encouraging the assumption of health care responsibility. As 25% of patients will be diagnosed with IBD before the age of 18 years, many will undergo this process. Efforts to enhance this process have included transition clinics and other means to improve patient comfort with transition and develop the skill of health care self-management. Currently, most pediatric practitioners provide transition care with informal education and emphasize independence without formal programs. A variety of tools to assess transition readiness have been developed. Given the varied disease process, often varied and subjective outcomes, and lack of studies such as randomized controlled trials, further data are necessary to determine the best avenue to transition and assess outcomes. Critically relevant to providing adequate care to transitioning patients includes understanding the development of self-management skills and the developmental processes relevant to young adults with IBD. Transition represents an area for quality improvement, and although progress has been made in recognition and promotion of transition practices, future directions in research will allow improved understanding of the evidence-based practices and needs of these individuals to further enhance their care.
炎症性肠病患者的过渡期护理重点是努力将护理从儿科提供者成功转移到成人提供者，同时鼓励其承担医疗保健责任。由于 25%的患者会在 18 岁之前被诊断为 IBD，因此许多患者将经历这一过程。为了加强这一过程，已经包括了过渡诊所和其他一些措施，以提高患者对过渡的舒适度，并培养自我保健管理技能。目前，大多数儿科医生提供过渡护理，采用非正式教育，并强调独立性，而没有正式的方案。已经开发出了多种评估过渡准备情况的工具。鉴于疾病过程的多样性、通常的多样性和主观的结果以及缺乏随机对照试验等研究，还需要进一步的数据来确定过渡的最佳途径和评估结果。为过渡患者提供充分护理的关键包括了解自我管理技能的发展以及与 IBD 年轻成年人相关的发展过程。过渡是一个质量改进的领域，尽管在认识和促进过渡实践方面已经取得了进展，但未来的研究方向将使人们进一步了解这些人的循证实践和需求，从而进一步加强他们的护理。
