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成人炎症性肠病治疗过渡:一项试点多中心、远程医疗混合干预研究

Transition to Adult IBD Care: A Pilot Multi-Site, Telehealth Hybrid Intervention.

机构信息

Department of Psychology, Auburn University.

Department of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center.

出版信息

J Pediatr Psychol. 2021 Jan 20;46(1):1-11. doi: 10.1093/jpepsy/jsaa088.

Abstract

OBJECTIVE

Transition to adult IBD care continues to be a challenge. Efficacious models of improving transition to adult care in the United States are lacking. We present data from a pilot, prospective, non-randomized, intervention implemented at IBD centers in the Midwest and Southeast United States.

DESIGN AND METHODS

Adolescents and young adults (AYAs; 16-20 years) with IBD and their parents completed a 4- to 5-month transition program (1 in-person group session; 4 individual telehealth sessions). Primary outcomes were feasibility (i.e., recruitment, retention, fidelity) and acceptability (i.e., program satisfaction). Secondary outcomes were changes in transition readiness, self-management skill acquisition, perceived readiness to transfer to adult care, and disease knowledge.

RESULTS

The study exceeded goals for recruitment (target N = 20; actual: 36) and retention (target: 80%; actual: 86.11%). On average, it took participants 20.91 ± 3.15 weeks to complete our 4- to 5-month intervention and there were no deviations from the study protocol. Participant ratings for overall program satisfaction, perceived helpfulness, and program length and format were positive. Increases in transition readiness, t(30) = 8.30, d = 1.49, p < .001, self-management skill acquisition, t(30) = 3.93, d = 0.70, p < .001, and disease knowledge, t(30) = 8.20, d = 1.58, p < .001 were noted. AYA- and parent-perceived transfer readiness also improved (p's < .05; d's = 0.76-1.68).

CONCLUSIONS

This article presents feasibility and acceptability data for a 4- to 5-month transition intervention. Improvements in AYA transition readiness, self-management skill acquisition, IBD knowledge, and AYA/parent perceived transfer readiness were also observed.

摘要

目的

向成人 IBD 护理的过渡仍然是一个挑战。美国缺乏改善向成人护理过渡的有效模式。我们介绍了在美国中西部和东南部 IBD 中心实施的一项试点、前瞻性、非随机干预的初步数据。

设计和方法

患有 IBD 的青少年和年轻人(16-20 岁)及其父母完成了为期 4-5 个月的过渡计划(1 次面对面小组会议;4 次个人远程医疗会议)。主要结果是可行性(即招募、保留、保真度)和可接受性(即对计划的满意度)。次要结果是过渡准备、自我管理技能的获得、对转移到成人护理的准备程度以及疾病知识的变化。

结果

该研究超过了招募目标(目标 N=20;实际:36)和保留目标(目标:80%;实际:86.11%)。平均而言,参与者完成我们的 4-5 个月干预措施需要 20.91±3.15 周,并且没有偏离研究方案。参与者对整体计划满意度、感知有用性以及计划长度和格式的评价均为正面。过渡准备、自我管理技能的获取、疾病知识均有所提高,t(30)=8.30,d=1.49,p<0.001;t(30)=3.93,d=0.70,p<0.001;t(30)=8.20,d=1.58,p<0.001。青少年和家长认为转移准备就绪的程度也有所提高(p<0.05;d=0.76-1.68)。

结论

本文介绍了一项 4-5 个月过渡干预的可行性和可接受性数据。青少年过渡准备、自我管理技能的获取、IBD 知识以及青少年/家长认为转移准备就绪的程度也有所提高。

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