Speller-Brown Barbara, Varty Maureen, Thaniel Lisa, Jacobs Marni B
1 Children's National Health System, Washington, DC, USA.
2 The George Washington University, Washington, DC, USA.
J Pediatr Oncol Nurs. 2018 Dec 19:1043454218819447. doi: 10.1177/1043454218819447.
Transition of medical care from pediatrics to adult can be challenging and difficult. Until the 1970s, only half of patients diagnosed with sickle cell disease (SCD) reached adulthood. As a result of patients living longer, there is a growing need to understand factors that influence readiness to transition. This descriptive study examined age-specific SCD knowledge, self-management skills of patients, and education goals in a convenience sample of patients and their parents.
One hundred eighty-three transition surveys were distributed during scheduled hematology clinic visits. Surveys were analyzed with descriptive statistics to determine differences of knowledge between age groups, self-care skills, vocational supports, and educational goals. The parent group consists of children aged 0 to 4 years (32), 5 to 8 years (52), 9 to 11 years (12); the child group consists of children aged 9 to 11 years (24) and 12 to 15 years (31); and adolescent and young adult (AYA) group consists of children aged 16 to 21 years (32).
Indeed, 50% of parents of the 0 to 4 years age group and 33% of 5 to 8 years age group knew their child's baseline hemoglobin. Only 38% of patients aged 16 to 21 years knew their baseline hemoglobin. However, 79% of patients aged 9 to 11 years, 74% of patient aged 12 to 15 years, and 78% of AYAs could name their hematology provider. Only 66% of patients aged 16 to 21 years knew what symptoms required medical attention.
Most patients and parents had adequate basic knowledge regarding SCD. AYAs lack the disease knowledge necessary to transition care away from parents to become more independent. An assessment for transition readiness should be ongoing to include disease-specific knowledge and self-management skills.
医疗护理从儿科向成人阶段的过渡可能具有挑战性且困难重重。直到20世纪70年代,只有一半被诊断患有镰状细胞病(SCD)的患者能活到成年。由于患者寿命延长,越来越需要了解影响过渡准备情况的因素。这项描述性研究在一个由患者及其父母组成的便利样本中,考察了特定年龄的SCD知识、患者的自我管理技能以及教育目标。
在预定的血液科门诊就诊期间发放了183份过渡调查问卷。运用描述性统计分析调查问卷,以确定不同年龄组在知识、自我护理技能、职业支持和教育目标方面的差异。父母组包括0至4岁儿童(32名)、5至8岁儿童(52名)、9至11岁儿童(12名);儿童组包括9至11岁儿童(24名)和12至15岁儿童(31名);青少年及青年成人(AYA)组包括16至21岁儿童(32名)。
确实,0至4岁年龄组的50%父母以及5至8岁年龄组的33%父母知道孩子的基线血红蛋白水平。16至21岁的患者中只有38%知道自己的基线血红蛋白水平。然而, 9至11岁的患者中有79%、12至15岁的患者中有74%以及AYA组中有78%能说出他们的血液科医生名字。16至21岁的患者中只有66%知道哪些症状需要就医。
大多数患者和父母对SCD有足够的基本知识。AYA缺乏将护理从父母那里过渡出来以变得更加独立所需的疾病知识。应该持续进行过渡准备情况评估,以纳入特定疾病知识和自我管理技能。