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多学科过渡时期项目(TAP)初始就诊的初步数据和病例示例。

Pilot data and case example of the initial visit in a multidisciplinary transition-age program (TAP).

机构信息

United Family Medicine Residency Program, 1026 West Seventh Street, St. Paul, MN 55012, United States.

Reger Neuropsychology Services, LLC, 4826 Chicago Avenue, Suite 203, Minneapolis, MN 55417, United States.

出版信息

Epilepsy Behav. 2020 Oct;111:107242. doi: 10.1016/j.yebeh.2020.107242. Epub 2020 Jul 3.

Abstract

The process of transition from pediatric to adult epilepsy care has received increased attention and emphasis in recent literature, particularly related to the assertion that effective transition is likely to lead to improved medical and psychosocial outcomes. However, the majority of current transition literature focuses on the structure of a transition program, with very little research providing relevant clinical data during the transition period and beyond. The current paper attempts to address this gap in the literature by providing pilot data on participants who engaged in the initial visit of a multidisciplinary transition-focused program housed in a level 4 epilepsy center in the Midwest. Pilot data are presented on 28 participants (36% female) who completed the initial transition appointment. All but one participant presented with a positive history for a neurobehavioral comorbidity, the most common of which included anxiety (61%), attention-deficit/hyperactivity disorder (ADHD; 39%) and depression (36%). Seventy-seven percent of participants further identified a current neurobehavioral comorbidity that was impacting their psychosocial functioning. Recommendations provided most frequently involved increased independence with epilepsy management (64%), increased independence with self-care/independent living (82%), psychological intervention (43%), and increased socialization (43%). A case example is also provided to further highlight program process and outcomes of the initial visit. Pilot results emphasize the value of multidisciplinary care involving psychosocial providers to facilitate a smooth transition between pediatric and adult healthcare.

摘要

从儿科到成人癫痫护理的过渡过程在最近的文献中受到了越来越多的关注和重视,特别是因为人们断言有效的过渡可能会导致更好的医疗和心理社会结果。然而,目前大多数关于过渡的文献都集中在过渡项目的结构上,很少有研究在过渡期间和之后提供相关的临床数据。本文试图通过提供中西部四级癫痫中心内一个多学科过渡为重点的项目的初始访视参与者的试点数据来填补这一文献空白。 试点数据来自 28 名参与者(36%为女性),他们完成了初始过渡预约。除了一名参与者之外,所有人都有神经行为共病的阳性病史,其中最常见的包括焦虑(61%)、注意缺陷/多动障碍(ADHD;39%)和抑郁(36%)。77%的参与者进一步确定了当前影响其心理社会功能的神经行为共病。提供的建议最常涉及增加癫痫管理的独立性(64%)、增加自我护理/独立生活的独立性(82%)、心理干预(43%)和增加社交(43%)。还提供了一个案例示例,以进一步强调初始访视的项目过程和结果。试点结果强调了涉及心理社会提供者的多学科护理的价值,以促进儿科和成人医疗保健之间的顺利过渡。

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