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加纳临床遗传学研究所镰状细胞病青少年和年轻成人的过渡准备和护理满意度。

Transition Preparation and Satisfaction of Care Among Adolescents and Young Adults With Sickle Cell Disease at the Ghana Institute of Clinical Genetics.

机构信息

Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA.

Department of Hematology, University of Ghana Medical School, Ghana Institute of Clinical Genetics, Korle Bu, Accra, Ghana.

出版信息

J Pediatr Hematol Oncol. 2022 Apr 1;44(3):e682-e688. doi: 10.1097/MPH.0000000000002316.

Abstract

Expanding services in Ghana for people with sickle cell disease is expected to increase childhood survival and need for transition to adult care. Little is known about patient transition experiences in sub-Saharan Africa. We sought to understand those experiences of adolescents and young adults at an adult sickle cell clinic in Accra, Ghana. Individuals 13 to 22 years of age receiving sickle cell care at the Ghana Institute of Clinical Genetics were interviewed to recall their advance preparation and early experiences in adult sickle cell clinic. Mean age of the 100 participants interviewed was 17.9±2.9 years, 65% female. Most had hemoglobin SS (77%) or hemoglobin SC (20%). Twenty-nine participants recalled pretransition preparation; 93% of them (27) had received care at Korle Bu Pediatric Sickle Cell Clinic. Among the remaining 71 who did not recall advance preparation, 54% (34) had received pediatric care at that clinic (P<0.001). More in the group recalling preparation had positive feelings about needing to transition care compared with those not recollecting preparation (55% vs. 32%, P=0.04). Our results suggest that pretransition preparation may ease the peritransition experience. Conduct and evaluation of a program for transitioning into adult sickle cell care in Ghana may facilitate the transfer process.

摘要

在加纳扩大镰状细胞病患者的服务范围有望提高儿童的生存率并需要过渡到成人护理。在撒哈拉以南非洲,人们对患者的过渡体验知之甚少。我们试图了解加纳阿克拉一家成人镰状细胞诊所的青少年和年轻人的这些经历。在加纳临床遗传学研究所接受镰状细胞护理的 13 至 22 岁的个体接受了采访,以回忆他们在成人镰状细胞诊所的提前准备和早期经历。接受采访的 100 名参与者的平均年龄为 17.9±2.9 岁,女性占 65%。大多数人患有血红蛋白 SS(77%)或血红蛋白 SC(20%)。29 名参与者回忆起过渡前的准备;其中 93%(27 人)曾在科勒布儿科镰状细胞诊所接受过治疗。在其余 71 名不记得提前准备的人中,54%(34 人)曾在该诊所接受过儿科治疗(P<0.001)。与未回忆起准备工作的人相比,在回忆起准备工作的人中,有更多人对需要过渡护理有积极的感受(55%比 32%,P=0.04)。我们的研究结果表明,过渡前的准备工作可能会减轻过渡期间的体验。在加纳开展过渡到成人镰状细胞护理的过渡计划的实施和评估可能会促进这一转变过程。

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