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成年期先天性巨结肠症患者:患者经历及过渡护理建议。

Reaching adulthood with Hirschsprung's disease: Patient experiences and recommendations for transitional care.

机构信息

Department of Pediatric Surgery, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Department of Pediatric Surgery, Skåne University Hospital and Department of Clinical Sciences, Lund University, Malmo, Sweden.

出版信息

J Pediatr Surg. 2021 Feb;56(2):257-262. doi: 10.1016/j.jpedsurg.2020.05.015. Epub 2020 May 16.

Abstract

BACKGROUND/PURPOSE: The need for transitional care has gained increased focus in the treatment of patients with congenital colorectal disorders. We aimed to acquire in-depth knowledge about the experiences of adult patients with Hirschsprung's disease (HD) and their suggestions for transitional care.

METHODS

Binational study applying gender equal focus group interviews (FGI).

RESULTS

Seventeen (9 men) of 52 invited patients with median age 29 (19-43) years participated. Three themes evolved from the FGI. "Scarred body and soul" describes the somatic and psychosocial challenges the patients experienced and "limited health literacy on HD" refers to the patients' lack of HD knowledge. "Absent transition" depicts missing transitional care and the patients' inability to find adult HD specialists. The adult HD patients strongly recommended transitional care from early teens with focus on information about HD and establishment of a peer-to-peer program. They also emphasized the possibility of being referred to a pelvic floor center.

CONCLUSIONS

HD negatively influences patients' somatic and psychosocial health in childhood, adolescence and adulthood. Adult HD patients strongly recommend transitional care from early teens and the possibility for referral to a center working with pelvic floor dysfunctions.

LEVEL OF EVIDENCE

IV TYPE OF RESEARCH: Clinical.

摘要

背景/目的:在先天性结直肠疾病患者的治疗中,过渡护理的需求受到了越来越多的关注。我们旨在深入了解先天性巨结肠症(HD)成年患者的经历,并了解他们对过渡护理的建议。

方法

采用两性平等重点小组访谈(FGI)的跨国研究。

结果

在 52 名受邀的患者中,有 17 名(9 名男性)患者参加了中位数年龄为 29 岁(19-43 岁)的 FGI。FGI 产生了三个主题。“身心伤痕累累”描述了患者所经历的躯体和心理社会挑战,“HD 健康素养有限”是指患者缺乏 HD 知识。“缺失的过渡”描绘了缺失的过渡护理以及患者无法找到成人 HD 专家的情况。成年 HD 患者强烈建议从青少年早期开始进行过渡护理,重点是提供有关 HD 的信息并建立同伴计划。他们还强调了向盆底中心转介的可能性。

结论

HD 在儿童、青少年和成年期会对患者的躯体和心理健康产生负面影响。成年 HD 患者强烈建议从青少年早期开始进行过渡护理,并有可能转介到专门治疗盆底功能障碍的中心。

证据水平

IV 研究类型:临床。

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