Duke University School of Nursing, Durham, NC, United States of America.
Duke University, United States of America.
J Pediatr Nurs. 2019 Jul-Aug;47:148-158. doi: 10.1016/j.pedn.2019.05.008. Epub 2019 May 29.
This study explored the health care transition (HCT) experiences of parents of adolescents and young adults (AYAs) with intellectual disability (ID), 18-33 years of age, including barriers and facilitators to the AYA's transition to adulthood within and between the medical, educational, community, and vocational systems.
A qualitative descriptive design with semi-structured individual interviews with 16 parent participants was used. Purposive sampling of parents was utilized with variation on race/ethnicity and AYA age, stage in transition, and condition. This study was conducted through a major medical center in the southeast United States. Content analysis was utilized.
Three overarching themes represented the factors and essence of supporting AYAs with ID transition to adulthood. Inefficient and siloed systems illuminated barriers families are commonly experiencing within and between the medical, educational, community, and vocational systems. 'Left out here floundering' in adulthood, described the continued inadequacy of resources within each of these systems and parent's having to find available resources themselves. Hope despite uncertainty, included the perceived costs and benefits of their AYA's disability and the value of parent peer support in providing key knowledge of resources, strategies, and perspectives.
Our findings illuminate the need for improved infrastructure to provide effective HCT and partnerships to help integrate HCT support within other life course systems. Results support the rationale for non-categorical HCT-focused approach.
A parent peer coach-facilitated intervention offers promise for bridging the gap between systems and meeting family needs.
本研究探讨了 18-33 岁患有智力障碍 (ID) 的青少年和年轻成人 (AYA) 父母的医疗过渡 (HCT) 经历,包括医疗、教育、社区和职业系统内和系统间 AYA 向成年过渡的障碍和促进因素。
采用定性描述设计,对 16 名家长参与者进行半结构化个体访谈。采用目的性抽样,考虑到种族/民族、AYA 年龄、过渡阶段和病情的差异。本研究在美国东南部的一家主要医疗中心进行。采用内容分析法。
三个总体主题代表了支持 ID AYA 向成年过渡的因素和本质。效率低下且孤立的系统揭示了家庭在医疗、教育、社区和职业系统内和系统间普遍面临的障碍。“成年后茫然无措”描述了这些系统中资源的持续不足,以及父母不得不自己寻找可用资源的情况。尽管存在不确定性,但仍充满希望,包括他们对 AYA 残疾的感知成本和收益,以及家长同伴支持在提供资源、策略和观点方面的关键知识的价值。
我们的研究结果表明,需要改善基础设施,以提供有效的 HCT,并建立合作伙伴关系,帮助将 HCT 支持融入其他生命历程系统。研究结果支持非分类 HCT 为重点的方法的合理性。
父母同伴教练促进的干预措施有望弥合系统之间的差距,并满足家庭的需求。