Department of Nursing, College of Health Sciences, Makerere University, Kampala, Uganda.
Department of Peadiatrics, College of Health Science, Makerere University, Kampala, Uganda.
PLoS One. 2021 Apr 29;16(4):e0249971. doi: 10.1371/journal.pone.0249971. eCollection 2021.
Transition readiness refers to a client who knows about his/her illness and oriented towards future goals and hopes, shows skills needed to negotiate healthcare, and can assume responsibility for his/ her treatment, and participate in decision-making that ensures uninterrupted care during and after the care transition to adult HIV care. There is a paucity of research on effective transition strategies. This study explored factors associated with adolescent readiness for the transition into adult care in Uganda.
A cross-sectional study was conducted among 786 adolescents, and young people living with HIV randomly selected from 9 antiretroviral therapy clinics, utilizing a structured questionnaire. The readiness level was determined using a pre-existing scale from the Ministry of Health, and adolescents were categorized as ready or not ready for the transition. Bivariate and multivariate analyses were conducted.
A total of 786 adolescents were included in this study. The mean age of participants was 17.48 years (SD = 4). The majority of the participants, 484 (61.6%), were females. Most of the participants, 363 (46.2%), had no education. The majority of the participants, 549 (69.8%), were on first-line treatment. Multivariate logistic regression analysis found that readiness to transition into adult care remained significantly associated with having acquired a tertiary education (AOR 4.535, 95% CI 1.243-16.546, P = 0.022), trusting peer educators for HIV treatment (AOR 16.222, 95% CI 1.835-143.412, P = 0.012), having received counselling on transition to adult services (AOR 2.349, 95% CI 1.004-5.495, P = 0.049), having visited an adult clinic to prepare for transition (AOR 6.616, 95% CI 2.435-17.987, P = < 0.001) and being satisfied with the transition process in general (AOR 0.213, 95% CI 0.069-0.658, P = 0.007).
The perceived readiness to transition care among young adults was low. A series of individual, social and health system and services factors may determine successful transition readiness among adolescents in Uganda. Transition readiness may be enhanced by strengthening the implementation of age-appropriate and individualized case management transition at all sites while creating supportive family, peer, and healthcare environments.
过渡准备是指患者了解自己的疾病，关注未来的目标和希望，具备协商医疗保健的技能，并能够为自己的治疗负责，参与确保在向成人艾滋病毒护理过渡期间和之后护理不间断的决策。关于有效的过渡策略的研究很少。本研究探讨了乌干达青少年过渡到成人护理的准备情况相关因素。
对来自 9 个抗逆转录病毒治疗诊所的 786 名随机选择的艾滋病毒感染青少年和年轻人进行了横断面研究，使用了结构化问卷。使用卫生部的现有量表确定准备水平，将青少年分为准备好或未准备好过渡。进行了单变量和多变量分析。
本研究共纳入 786 名青少年。参与者的平均年龄为 17.48 岁（标准差=4）。大多数参与者为女性，共 484 名（61.6%）。大多数参与者没有受过教育，共 363 名（46.2%）。大多数参与者正在接受一线治疗，共 549 名（69.8%）。多变量逻辑回归分析发现，过渡到成人护理的准备状态与获得高等教育（优势比 4.535，95%置信区间 1.243-16.546，P=0.022）、信任艾滋病毒治疗同伴教育者（优势比 16.222，95%置信区间 1.835-143.412，P=0.012）、接受过关于过渡到成人服务的咨询（优势比 2.349，95%置信区间 1.004-5.495，P=0.049）、已前往成人诊所为过渡做准备（优势比 6.616，95%置信区间 2.435-17.987，P<0.001）和对过渡过程总体满意（优势比 0.213，95%置信区间 0.069-0.658，P=0.007）显著相关。
乌干达年轻成年人的过渡护理准备意识较低。一系列个人、社会和卫生系统及服务因素可能决定青少年成功过渡准备。通过在所有地点加强实施适合年龄和个性化的病例管理过渡，同时营造支持家庭、同伴和医疗保健环境，可以增强过渡准备。
