South Katherine, George Maureen, Smaldone Arlene
Columbia University School of Nursing, New York, NY, USA.
J Transit Med. 2022 Jul 12;4(1):20220002. doi: 10.1515/jtm-2022-0002. eCollection 2022 Jan 1.
Measuring transition readiness is important when preparing young people with chronic illness for successful transition to adult care. The Expanded Socioecological Model of Adolescent and Young Adult Readiness to Transition (Expanded SMART) offers a holistic view of factors that influence transition readiness and outcomes. The aim of this study was to examine conceptual congruency of transition readiness instruments with the Expanded SMART to determine the breadth and frequency of constructs measured.
PubMed was searched to identify observational and experimental studies that measured transition readiness across chronic illnesses. Selected instruments were first evaluated on their development and psychometric properties. Next, reviewers independently mapped each instrument item to Expanded SMART constructs: knowledge, skills/self-efficacy, relationships/communication, psychosocial/emotions, developmental maturity, beliefs/expectations, goals/motivation. If items did not map to a construct, a new construct was named inductively through group discussion.
Three instruments (TRAQ [20 items], STARx [18 items] and TRxANSITION Index [32 items]), reported in 74 studies, were identified. Across instruments, most items mapped to three constructs: skills/self-efficacy, developmental maturity, and knowledge. The psychosocial constructs of goals/motivation and psychosocial/emotions were underrepresented in the instruments. No instrument mapped to every model construct. Two new constructs: and were identified.
Constructs representing transition readiness in three frequently used transition readiness instruments vary considerably from Expanded SMART, a holistic conceptual model of transition readiness, suggesting that conceptualization and operationalization of transition readiness is not standardized. No instrument reflected all conceptual constructs of transition readiness and psychosocial constructs were underrepresented, suggesting that current instruments may provide an incomplete measurement of transition readiness.
在为患有慢性病的年轻人准备顺利过渡到成人护理时，衡量过渡准备情况很重要。青少年和青年成人过渡准备的扩展社会生态模型（扩展SMART）提供了一个影响过渡准备情况和结果的因素的整体视图。本研究的目的是检验过渡准备情况工具与扩展SMART的概念一致性，以确定所测量结构的广度和频率。
检索PubMed以识别测量各种慢性病过渡准备情况的观察性和实验性研究。首先根据其开发和心理测量特性对选定的工具进行评估。接下来，评审人员独立地将每个工具项目映射到扩展SMART结构：知识、技能/自我效能、关系/沟通、心理社会/情绪、发育成熟度、信念/期望、目标/动机。如果项目未映射到某个结构，则通过小组讨论归纳命名一个新结构。
确定了74项研究中报告的三种工具（TRAQ[20项]、STARx[18项]和TRxANSITION指数[32项]）。在所有工具中，大多数项目映射到三个结构：技能/自我效能、发育成熟度和知识。目标/动机和心理社会/情绪的心理社会结构在工具中代表性不足。没有一个工具映射到每个模型结构。确定了两个新结构： 和 。
三种常用的过渡准备情况工具中代表过渡准备情况的结构与过渡准备情况的整体概念模型扩展SMART有很大差异，这表明过渡准备情况的概念化和操作化并不标准化。没有一个工具反映过渡准备情况的所有概念结构，并且心理社会结构代表性不足，这表明当前工具可能无法完整测量过渡准备情况。
