决策参与、自我效能感与镰状细胞病青少年的过渡准备
Decision-Making Involvement, Self-Efficacy, and Transition Readiness in Youth With Sickle Cell Disease.
出版信息
Nurs Res. 2022;71(1):12-20. doi: 10.1097/NNR.0000000000000550.
BACKGROUND
Transition to adult healthcare is a critical time for adolescents and young adults (AYAs) with sickle cell disease, and preparation for transition is important to reducing morbidity and mortality risks associated with transition.
OBJECTIVE
We explored the relationships between decision-making involvement, self-efficacy, healthcare responsibility, and overall transition readiness in AYAs with sickle cell disease prior to transition.
METHODS
This cross-sectional, correlational study was conducted with 50 family caregivers-AYAs dyads receiving care from a large comprehensive sickle cell clinic between October 2019 and February 2020. Participants completed the Decision-Making Involvement Scale, the Sickle Cell Self-Efficacy Scale, and the Readiness to Transition Questionnaire. Multiple linear regression was used to assess the relationships between decision-making involvement, self-efficacy, healthcare responsibility, and overall transition readiness in AYAs with sickle cell disease prior to transition to adult healthcare.
RESULTS
Whereas higher levels of expressive behaviors, such as sharing opinions and ideas in decision-making, were associated with higher levels of AYA healthcare responsibility, those behaviors were inversely associated with feelings of overall transition readiness. Self-efficacy was positively associated with overall transition readiness but inversely related to AYA healthcare responsibility. Parent involvement was negatively associated with AYA healthcare responsibility and overall transition readiness.
DISCUSSION
While increasing AYAs' decision-making involvement may improve AYAs' healthcare responsibility, it may not reduce barriers of feeling unprepared for the transition to adult healthcare. Facilitating active AYA involvement in decision-making regarding disease management, increasing self-efficacy, and safely reducing parent involvement may positively influence their confidence and capacity for self-management.
背景
对于患有镰状细胞病的青少年和年轻成年人（AYA）来说，过渡到成人医疗保健是一个关键时期，过渡前的准备对于降低与过渡相关的发病率和死亡率风险很重要。
目的
我们在 AYA 过渡到镰状细胞病之前，探讨了决策参与、自我效能、医疗保健责任和整体过渡准备之间的关系。
方法
这是一项横断面相关性研究，共纳入 2019 年 10 月至 2020 年 2 月期间在一家大型综合性镰状细胞诊所接受治疗的 50 个家庭照顾者-AYA 对。参与者完成了决策参与量表、镰状细胞自我效能量表和过渡准备问卷。多元线性回归用于评估 AYA 过渡到成人医疗保健之前的决策参与、自我效能、医疗保健责任和整体过渡准备之间的关系。
结果
表达性行为（例如在决策中分享意见和想法）水平较高与 AYA 医疗保健责任水平较高相关，而这些行为与整体过渡准备的感觉呈负相关。自我效能与整体过渡准备呈正相关，但与 AYA 医疗保健责任呈负相关。父母的参与与 AYA 医疗保健责任和整体过渡准备呈负相关。
讨论
虽然增加 AYA 的决策参与度可能会提高 AYA 的医疗保健责任，但这可能不会减少对过渡到成人医疗保健的准备不足的障碍。促进 AYA 积极参与疾病管理的决策、提高自我效能以及安全减少父母的参与可能会积极影响他们的信心和自我管理能力。
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