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促进患有长期健康问题的年轻人从儿童医疗服务向成人医疗服务的过渡——一项为期5年研究项目的启示

Facilitating transition of young people with long-term health conditions from children's to adults' healthcare services - implications of a 5-year research programme.

作者信息

Colver Allan, Rapley Tim, Parr Jeremy R, McConachie Helen, Dovey-Pearce Gail, Couteur Ann Le, McDonagh Janet E, Bennett Caroline, Maniatopoulos Gregory, Pearce Mark S, Reape Debbie, Chater Nichola, Gleeson Helena, Vale Luke

机构信息

Northumbria Healthcare NHS Foundation Trust, North Shields, UK and Newcastle University, Newcastle upon Tyne, UK

Northumbria University, Newcastle upon Tyne, UK.

出版信息

Clin Med (Lond). 2020 Jan;20(1):74-80. doi: 10.7861/clinmed.2019-0077.

Abstract

BACKGROUND

During transition from children's to adults' healthcare, young adults with long-term conditions may show delays in psychosocial development compared to their peers without long-term conditions, and deterioration of their conditions' medical control.

METHODS

This paper integrates the findings, already published in 10 separate papers, of a 5-year transition research programme.

IMPLICATIONS

There is an important role for funders (commissioners) of adults' services to fund transitional healthcare, in addition to funders of children's services who currently take responsibility.It is important that healthcare provider organisations adopt an organisation-wide approach to implementation to ensure that good practice is adopted in children's and adults' services, not just adopted by enthusiasts in some specialties. This includes provision of 'developmentally appropriate healthcare' which recognises the changing biopsychosocial developmental needs of young people.Three features of transitional healthcare were associated with improved outcomes: appropriate parent involvement, promotion of young people's confidence in managing their health and meeting the adult team before transfer. These should be maintained or introduced as a priority.Child and adult healthcare providers should routinely explore with a young person how they approach transition and personalise their clinical approach thereafter.These implications are relevant for a range of stakeholders, including funders of transitional healthcare, organisations providing transitional healthcare and clinical practitioners.

摘要

背景

在从儿童医疗向成人医疗过渡期间,患有长期疾病的年轻人与没有长期疾病的同龄人相比,心理社会发展可能会出现延迟,其疾病的医疗控制也会恶化。

方法

本文整合了一项为期5年的过渡研究项目的研究结果,这些结果已发表在10篇独立的论文中。

启示

除了目前承担责任的儿童服务资助者外,成人服务的资助者(委托方)在资助过渡性医疗保健方面也可发挥重要作用。医疗保健服务提供机构采用全机构范围的实施方法很重要,以确保儿童和成人服务都采用良好做法,而不仅仅是某些专业领域的热心人士采用。这包括提供“适合发育阶段的医疗保健”,即认识到年轻人不断变化的生物心理社会发展需求。过渡性医疗保健的三个特征与更好的结果相关:适当的家长参与、增强年轻人对管理自身健康的信心以及在转诊前与成人团队会面。应优先保持或引入这些特征。儿童和成人医疗保健服务提供者应定期与年轻人探讨他们如何应对过渡,并在此后使临床方法个性化。这些启示对一系列利益相关者都有意义,包括过渡性医疗保健的资助者、提供过渡性医疗保健的机构和临床从业者。

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