Iversen Elisabeth, Kolltveit Beate-Christin H, Hernar Ingvild, Mårtensson Jan, Haugstvedt Anne
Department of Medicine, Haukeland University Hospital, Bergen, Norway.
Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
Scand J Caring Sci. 2019 Sep;33(3):723-730. doi: 10.1111/scs.12668. Epub 2019 Mar 13.
The aim of the present study was to explore how young adults with type 1 diabetes (T1D) experienced the transition from paediatric to adult health care services.
A qualitative, explorative design was used.
Eleven young adults with T1D receiving adult diabetes care at a hospital in western Norway participated in semi-structured interviews. Data were analysed using Interpretive Description, an inductive approach inspired by grounded theory, ethnography and phenomenology, and specifically designed to explore phenomena in clinical practice aiming to generate new knowledge and skills.
Four main themes regarding the adolescents' experiences of the transfer from paediatric to adult care emerged: (i) limited information about the transition; (ii) transition from frequent, thorough and personal follow-up to a less comprehensive and less personal follow-up; (iii) the importance of being seen as a whole person; (iv) limited expectations of how the health care services were organised.
The study showed that the existing routines for transfer between paediatric and adult care are not optimal. The participants expressed that they were not prepared for the dissimilarities in follow-up and were predominantly less pleased with the adult care follow-up.
The findings support a need for structured transition programmes, that is programmes that contribute to young adults with T1D receiving a safe and positive transition at an otherwise demanding life phase. Young peoples' individual needs for the transition to and follow-up in adult care may be promoted by an approach based on person-centred care.
本研究旨在探讨1型糖尿病（T1D）青年患者如何体验从儿科到成人医疗服务的过渡。
采用定性、探索性设计。
11名在挪威西部一家医院接受成人糖尿病护理的T1D青年患者参与了半结构化访谈。使用诠释性描述分析法对数据进行分析，这是一种受扎根理论、民族志和现象学启发的归纳法，专门设计用于探索临床实践中的现象，旨在产生新的知识和技能。
出现了四个关于青少年从儿科护理过渡到成人护理体验的主要主题：（i）关于过渡的信息有限；（ii）从频繁、全面和个性化的随访过渡到不太全面和不太个性化的随访；（iii）被视为一个完整的人的重要性；（iv）对医疗服务组织方式的期望有限。
该研究表明，儿科和成人护理之间现有的过渡常规并非最佳。参与者表示，他们对随访中的差异没有做好准备，并且对成人护理随访大多不太满意。
研究结果支持需要结构化的过渡计划，即有助于T1D青年患者在这个原本要求较高的生命阶段实现安全且积极过渡的计划。基于以患者为中心的护理方法可以促进年轻人在向成人护理过渡及后续过程中的个人需求。
