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患有胃肠病、肾病和风湿病的青少年在向成人护理过渡期间的生活质量、家庭和同伴支持的作用。

The roles of quality of life and family and peer support in feelings about transition to adult care in adolescents with gastroenterology, renal, and rheumatology diseases.

机构信息

Section of Psychology and Renal Service, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin, Houston, TX 77030, USA.

Sections of Adolescent Medicine & Sports Medicine and Pediatric Psychology, Department of Pediatrics, Baylor College of Medicine & Texas Children's Hospital, 6701 Fannin, Suite 1710, Houston, TX 77030, USA.

出版信息

J Pediatr Nurs. 2022 Jan-Feb;62:193-199. doi: 10.1016/j.pedn.2021.04.032. Epub 2021 Jun 9.

Abstract

PURPOSE

Transition to adult healthcare is a critical time in the lives of adolescents with chronic medical conditions, with clear impacts on health outcomes. Little is known about factors that impact feelings about healthcare transition, including HRQOL, family and peer support, and utilization of a framework such as the SMART Model can guide exploration of these factors. The goal of this study is to examine how HRQOL (i.e., functional impact of disease) and family and peer support may impact adolescents' feelings about healthcare transition.

DESIGN AND METHODS

135 adolescents (17-23 years) with chronic gastroenterology, renal, or rheumatology disease completed four questionnaires as part of a larger study examining health, relationships, and healthcare transition. Questions assessed current HRQOL (i.e., number of days health was "not good"), peer and family support, and feelings about transition. Data were analyzed using SPSSv25 and linear regressions were performed.

RESULTS

Lower HRQOL (β = 0.283, p < .01) and less peer support (β = -0.198, p < .05) were associated with worse feelings about transition (R = 0.203, p < .001). Family support was significantly correlated at the bivariate level. There were no differences by type of disease, race/ethnicity, or gender that impacted study findings.

CONCLUSION(S): Results are concerning as healthcare transition is a milestone for every patient. Lower HRQOL (i.e., greater functional impact of disease) and less peer support were associated with worse feelings about transition.

PRACTICE IMPLICATIONS

This study highlights potential targets for intervention such as improving HRQOL (e.g., acceptance and commitment therapy) and increasing peer support (e.g., social skills training, family facilitation) to improve transition to adult care for pediatric patients with chronic diseases.

摘要

目的

对于患有慢性疾病的青少年来说,过渡到成人保健是其生命中的一个关键时期,这对健康结果有着明显的影响。目前人们对影响医疗过渡感受的因素知之甚少,包括 HRQOL、家庭和同伴支持,以及利用 SMART 模型等框架可以指导对这些因素的探索。本研究的目的是探讨 HRQOL(即疾病对功能的影响)和家庭及同伴支持如何影响青少年对医疗过渡的感受。

设计和方法

135 名(17-23 岁)患有慢性胃肠病、肾脏或风湿病的青少年作为更大规模研究的一部分,完成了四份问卷,该研究调查了健康、人际关系和医疗过渡。问题评估了当前的 HRQOL(即健康“不佳”的天数)、同伴和家庭支持以及对过渡的感受。数据使用 SPSSv25 进行分析,并进行线性回归。

结果

较低的 HRQOL(β=0.283,p<.01)和较少的同伴支持(β=-0.198,p<.05)与对过渡的较差感受相关(R=0.203,p<.001)。家庭支持在双变量水平上具有显著相关性。研究结果不受疾病类型、种族/民族或性别差异的影响。

结论

研究结果令人担忧,因为医疗过渡是每个患者的一个重要里程碑。较低的 HRQOL(即疾病对功能的影响更大)和较少的同伴支持与对过渡的较差感受相关。

实践意义

本研究强调了潜在的干预目标,例如提高 HRQOL(例如,接受和承诺疗法)和增加同伴支持(例如,社交技能训练,家庭促进),以改善患有慢性疾病的儿科患者向成人护理的过渡。

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