Division of Endocrinology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.
BMJ Open Qual. 2022 Jan;11(1). doi: 10.1136/bmjoq-2021-001563.
The need to better prepare youth with type 1 diabetes for the transition from paediatric to adult care is evident. As part of a regional quality improvement initiative, a novel Pre-Transition (Pre-T) Visit was developed and piloted at a paediatric tertiary care centre in January 2018 for patients aged 15-18 years to capture the status of their self-management skills, introduce transition tools and identify self-care goals and knowledge gaps to be addressed prior to transition.
To evaluate patient and family satisfaction, visit relevance and patient engagement with a novel Pre-T Visit.
From May 2019 to March 2020 a survey was offered to all youth who attended a Pre-T Visit and their parent(s)/caregiver(s). Patient and family satisfaction with, relevance of and engagement with the Pre-T Visit were evaluated using a 5-point Likert scale. Multivariable regression was used to assess patient factors associated with patient level satisfaction.
Of the 63 youth who participated in a Pre-T Visit, 60 completed the survey. Mean age (SD) of participants was 16.7 (0.8) years; 47% were female. Mean (SD) haemoglobin A1C (A1C) was 8.2% (1.8). Patients reported high levels of satisfaction (95% quite or extremely satisfied) that were consistent across age, A1C, gender and disease duration. Visit relevance and engagement were also rated highly by youth. Parent participants (n=27) also reported high levels of satisfaction (89% quite or extremely satisfied) and relevance.
Pre-T Visits were rated highly by patients and their parents. Their impact on glycaemic control and health outcomes following transition requires further study.
显而易见，需要更好地让患有 1 型糖尿病的年轻人做好从儿科过渡到成人护理的准备。作为区域质量改进计划的一部分，2018 年 1 月，一家儿科三级保健中心为 15-18 岁的患者开发并试行新的预过渡（Pre-T）就诊，以了解他们自我管理技能的状况，介绍过渡工具，并确定在过渡之前需要解决的自我护理目标和知识差距。
评估新型 Pre-T 就诊在患者和家属满意度、就诊相关性和患者参与度方面的效果。
2019 年 5 月至 2020 年 3 月，向所有参加 Pre-T 就诊的青少年及其父母/照顾者提供了一份调查。使用 5 分李克特量表评估患者和家属对 Pre-T 就诊的满意度、相关性和参与度。使用多变量回归分析评估与患者满意度相关的患者因素。
63 名参加 Pre-T 就诊的青少年中，有 60 名完成了调查。参与者的平均年龄（标准差）为 16.7（0.8）岁；47%为女性。平均（标准差）糖化血红蛋白（A1C）为 8.2%（1.8）。患者报告的满意度水平较高（95%非常满意或极其满意），且不受年龄、A1C、性别和疾病持续时间的影响。就诊的相关性和参与度也得到了青少年的高度评价。家长参与者（n=27）也报告了较高的满意度（89%非常满意或极其满意）和相关性。
Pre-T 就诊受到患者及其家长的高度评价。它们对过渡后血糖控制和健康结果的影响需要进一步研究。
