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医学生导师在改善镰状细胞病患者转归中的可行性研究

Feasibility of Medical Student Mentors to Improve Transition in Sickle Cell Disease.

机构信息

Rutgers Cancer Institute of New Jersey.

Rutgers Robert Wood Johnson Medical School.

出版信息

J Pediatr Psychol. 2021 Jul 20;46(6):650-661. doi: 10.1093/jpepsy/jsab031.

Abstract

OBJECTIVE

Advances in medical care have resulted in nearly 95% of all children with sickle cell disease (SCD) living to adulthood. There is a lack of effective transition programming, contributing to high rates of mortality and morbidity among adolescents and young adults (AYAs) during the transition from pediatric to adult healthcare. This nonrandomized study evaluated the feasibility, acceptability, and preliminary outcomes of a novel medical student mentor intervention to improve transition outcomes for AYA with SCD.

METHODS

Eligible participants were ages 18-25 years, either preparing for transition or had transferred to adult care within the past year. Twenty-four AYA with SCD (Mage = 20.3, SD = 2.6) enrolled in the program and were matched with a medical student mentor. Feasibility and acceptability of the intervention was assessed through enrollment rates, reasons for refusal, retention rates, engagement with the intervention, satisfaction, and reasons for drop-out. Dependent t-tests were used to evaluate the preliminary effects of the intervention on patient transition readiness, health-related quality of life, self-efficacy, SCD knowledge, medication adherence, and health literacy.

RESULTS

Participants (N = 24) demonstrated adequate retention (75.0%), adherence to the intervention (M = 5.3 of 6 sessions), and satisfaction with the intervention components. Participants demonstrated significant improvements in transition readiness (p = .001), self-efficacy (p = .002), medication adherence (p = .02), and health literacy (p = .05).

CONCLUSIONS

A medical student mentor intervention to facilitate transition from pediatric to adult care for AYA with SCD is both feasible and acceptable to patients and medical students. Preliminary results suggest benefits for patients, warranting a larger efficacy study.

摘要

目的

医疗技术的进步使近 95%的镰状细胞病(SCD)患儿能够活到成年。由于缺乏有效的过渡计划,导致青少年和年轻成年人(AYAs)在从儿科到成人医疗保健过渡期间的死亡率和发病率居高不下。这项非随机研究评估了一种新型医学生导师干预措施的可行性、可接受性和初步结果,该措施旨在改善 SCD AYA 的过渡结果。

方法

符合条件的参与者年龄在 18-25 岁之间,要么正在为过渡做准备,要么在过去一年已转至成人护理。24 名 SCD AYA(Mage=20.3,SD=2.6)参加了该计划,并与一名医学生导师配对。通过入组率、拒绝原因、保留率、对干预的参与度、满意度和退出原因来评估干预措施的可行性和可接受性。使用依赖样本 t 检验评估干预对患者过渡准备、健康相关生活质量、自我效能、SCD 知识、药物依从性和健康素养的初步效果。

结果

参与者(N=24)表现出足够的保留率(75.0%)、对干预的依从性(M=6 次干预中的 5.3 次)和对干预组成部分的满意度。参与者在过渡准备(p=.001)、自我效能(p=.002)、药物依从性(p=.02)和健康素养(p=.05)方面均表现出显著改善。

结论

为 SCD AYA 从儿科到成人护理的过渡提供医学生导师干预措施在患者和医学生中既可行又可接受。初步结果表明对患者有益,值得进行更大规模的疗效研究。

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