Lapp Valerie, Chase Susan K
University of Central Florida, College of Nursing, Orlando, USA; Arnold Palmer Hospital for Children, Orlando, FL, USA.
University of Central Florida, College of Nursing, Orlando, USA.
J Pediatr Nurs. 2018 Nov-Dec;43:104-110. doi: 10.1016/j.pedn.2018.09.012. Epub 2018 Sep 28.
To describe how perceived stages of change for self-care management skills varies by age in youth with cystic fibrosis in preparation for transition to adult healthcare, to compare caregiver perception of youth readiness for self-care, and age/frequency of transition discussion with provider.
The Transition Readiness Assessment Questionnaire and a modified version (TRAQ-C) for caregivers were used for data collection. Descriptive statistics, simple linear regression, and t-tests were employed.
Regression equations suggest that age predicts youth perception of self-care management skill in all five domains on the TRAQ (p ≤ .009). A paired t-test compared the overall TRAQ and TRAQ-C mean scores between dyads. Youth rated themselves significantly higher in perception of self-care skill management (m = 3.187, sd = 0.769) than caregivers (m = 2.490, sd = 0.788; t = 7.408, df = 51, p < .001). Sixteen was the average age of transition discussion for both youth and caregiver. Reported frequency of discussion varied considerably.
Although increasing age predicts perception of self-care management, many youth age 18-22 were still only contemplating or starting to learn skills. Skill level perceptions between youth and caregiver differed, but scores from all self-care management domains followed a similar trend. Discussions with providers began later than guidelines recommend and were often not recognized as such by youth.
Results underscore the importance of beginning transition discussion and skill evaluation in youth with cystic fibrosis at an early age, incorporating caregivers' perception in the process.
描述在准备向成人医疗保健过渡的囊性纤维化青少年中，自我护理管理技能的感知变化阶段如何随年龄而变化，比较照顾者对青少年自我护理准备情况的感知，以及与医疗服务提供者进行过渡讨论的年龄/频率。
使用过渡准备评估问卷和照顾者使用的修改版（TRAQ-C）进行数据收集。采用描述性统计、简单线性回归和t检验。
回归方程表明，年龄可预测青少年在TRAQ所有五个领域对自我护理管理技能的感知（p≤0.009）。配对t检验比较了二元组之间TRAQ和TRAQ-C的总体平均得分。青少年对自我护理技能管理的感知评分（m = 3.187，sd = 0.769）显著高于照顾者（m = 2.490，sd = 0.788；t = 7.408，df = 51，p < 0.001）。青少年和照顾者进行过渡讨论的平均年龄均为16岁。报告的讨论频率差异很大。
尽管年龄增长可预测对自我护理管理的感知，但许多18 - 22岁的青少年仍只是在考虑或开始学习技能。青少年和照顾者之间的技能水平感知存在差异，但所有自我护理管理领域的得分都遵循类似趋势。与医疗服务提供者的讨论开始时间晚于指南建议，且青少年往往未意识到这一点。
结果强调了在囊性纤维化青少年早期开始过渡讨论和技能评估的重要性，并在过程中纳入照顾者的感知。
