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从儿科到成人保健过渡准备对长期患病儿童-家长对子代生活质量的影响。

Influence of transition readiness from paediatric to adult health care on quality of life in child-parent dyads with long-term conditions.

机构信息

Shanghai Jiao Tong University School of Nursing, Shanghai, China.

出版信息

J Adv Nurs. 2021 May;77(5):2340-2352. doi: 10.1111/jan.14758. Epub 2021 Jan 10.

Abstract

AIM

To delineate the impact of perspective of children's transition readiness from paediatric to adult health care on quality of life in child-parent dyads with long-term conditions. We used Actor-Partner Interdependence Model to identify actor effects (effect of one's own transition readiness on one's own quality of life) and partner effects (effect of one's own transition readiness on the partner's quality of life).

DESIGN

A multi-centre cross-sectional survey.

METHODS

The study was conducted in two paediatric hospitals in China from October 2018-August 2019. We used a researcher-designed questionnaire to collect demographic and clinical characteristics. Furthermore, we used four questionnaires assessing transition readiness and quality of life in child and parent respectively to collect data from 370 child-parent dyads. Structural equation modelling was applied to estimate the effect of actor-partner interdependence models.

RESULTS

The total score of transition readiness had two actor effects on total child and parent quality of life controlling for age (β  = 3.335, p = .032 and β  = 8.952, p < .001), while only one actor effect controlling for gender (β  = 8.891, p < .001). Specific transition readiness dimensions had different partner effects on different domains of children and parents' quality of life. Moreover, younger children and fathers had a better quality of life.

CONCLUSION

Our study verified inherently interpersonal relationship that transition readiness appeared to influence quality of life in child-parent dyads with long-term conditions.

IMPACT

This study was the first to verify mutual influence of transition readiness and quality of life in child-parent dyad using actor-partner interdependence model. Nurses who design the transition promoting programs should consider the effective communication between healthcare provider and child-parent dyads and support parents' involvement to improve shared understanding about managing child's condition, especially for older children and mothers.

摘要

目的

从儿科到成人保健的儿童过渡准备度视角来描绘对长期疾病患儿-家长对子的生活质量的影响。我们使用演员-伙伴相互依赖模型来识别演员效应(自身过渡准备度对自身生活质量的影响)和伙伴效应(自身过渡准备度对伙伴生活质量的影响)。

设计

一项多中心横断面调查。

方法

本研究于 2018 年 10 月至 2019 年 8 月在中国的两家儿科医院进行。我们使用研究人员设计的问卷收集人口统计学和临床特征。此外,我们使用四个分别评估儿童和家长过渡准备度和生活质量的问卷从 370 个患儿-家长对子中收集数据。结构方程模型用于估计演员-伙伴相互依赖模型的效应。

结果

在控制年龄的情况下,过渡准备度的总分对儿童和家长的总生活质量有两个演员效应(β=3.335,p=0.032 和β=8.952,p<0.001),而仅在控制性别时,一个演员效应(β=8.891,p<0.001)。特定的过渡准备度维度对儿童和家长生活质量的不同领域有不同的伙伴效应。此外,年龄较小的儿童和父亲生活质量较好。

结论

我们的研究验证了内在的人际关系,即过渡准备度似乎会影响长期疾病患儿-家长对子的生活质量。

影响

本研究首次使用演员-伙伴相互依赖模型验证了过渡准备度和患儿-家长对子生活质量之间的相互影响。设计过渡促进计划的护士应考虑医疗保健提供者与患儿-家长对子之间的有效沟通,并支持父母的参与,以提高对管理儿童病情的共同理解,特别是对年龄较大的儿童和母亲。

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