Anton Corinne M, Anton Kristin, Butts Ryan J
Department of Cardiology, Children's Health - Children's Medical Center, Dallas, TX, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Pediatr Transplant. 2019 Nov;23(7):e13544. doi: 10.1111/petr.13544. Epub 2019 Jul 25.
Transition to adult health care has become a mainstream focus in pediatric health care as a higher percentage of patients are surviving into adulthood. This study investigated the success of a structured educational transition program in improving pediatric heart transplant patients' overall medical knowledge, medication adherence, readiness to transition, as well as parental perceptions of their child's readiness to transition to aid in the successful transition to an adult heart transplant program. Patients underwent a structured transition program over 2 years that included a total of seven 2-hour educational sessions hosted quarterly. This study comprised of a retrospective review of 12 heart transplant patients between the ages of 16-22 years. Test results indicated a statistically significant increase in overall medical knowledge scores from presession assessment compared to post-session assessment. Participants remained confident in their ability to transition throughout the program. Further, a statistically significant decrease in participant non-adherence was observed, as percentage of calcineurin inhibitor levels determined to be out of range decreased over the course of the program. Results suggest that a structured transition program is effective in improving overall patient medical knowledge in relation to their heart transplant and enhancing patient medication adherence. To effectively facilitate transition, pediatric providers, caregivers, and patients must communicate to provide a purposeful planned transition experience from pediatric to adult health care.
随着越来越多的患者存活至成年，向成人医疗保健的过渡已成为儿科医疗保健的一个主流关注点。本研究调查了一个结构化教育过渡项目在提高小儿心脏移植患者的整体医学知识、药物依从性、过渡准备情况以及家长对其孩子过渡到成人心脏移植项目准备情况的认知方面的成效，以帮助成功过渡到成人心脏移植项目。患者在两年内接受了一个结构化过渡项目，该项目总共包括七个每季度举办一次的两小时教育课程。本研究包括对12名年龄在16至22岁之间的心脏移植患者的回顾性分析。测试结果表明，与课后评估相比，课前评估的整体医学知识得分有统计学意义的显著提高。参与者在整个项目中对自己的过渡能力保持信心。此外，观察到参与者不依从情况有统计学意义的显著下降，因为在项目过程中，确定超出范围的钙调神经磷酸酶抑制剂水平的百分比有所下降。结果表明，一个结构化过渡项目在提高患者关于心脏移植的整体医学知识以及增强患者药物依从性方面是有效的。为了有效地促进过渡，儿科医疗服务提供者、护理人员和患者必须进行沟通，以提供从儿科到成人医疗保健的有目的、有计划的过渡体验。
