Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.
Department of Surgery and Perioperative Care The University of Texas at Austin Dell Medical School Austin TX.
J Am Heart Assoc. 2023 Mar 7;12(5):e027556. doi: 10.1161/JAHA.122.027556. Epub 2023 Feb 21.
Background The lifetime journey of patients with single-ventricle congenital heart disease is characterized by long-term challenges that are incompletely understood and still unfolding. Health care redesign requires a thorough understanding of this journey to create and implement solutions that improve outcomes. This study maps the lifetime journey of individuals with single-ventricle congenital heart disease and their families, identifies the most meaningful outcomes to them, and defines significant challenges in the journey. Methods and Results This qualitative research study involved experience group sessions and 1:1 interviews of patients, parents, siblings, partners, and stakeholders. Journey maps were created. The most meaningful outcomes to patients and parents and significant gaps in care were identified across the life journey. A total of 142 participants from 79 families and 28 stakeholders were included. Lifelong and life-stage specific journey maps were created. The most meaningful outcomes to patients and parents were identified and categorized using a "" framework. Gaps in care were identified and classified into areas of ineffective communication, lack of seamless transitions, lack of comprehensive support, structural deficiencies, and insufficient education. Conclusions There are significant gaps in care during the lifelong journey of individuals with single-ventricle congenital heart disease and their families. A thorough understanding of this journey is a critical first step in developing initiatives to redesign care around their needs and priorities. This approach can be used for people with other forms of congenital heart disease and other chronic conditions. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT04613934.
背景 患有单心室先天性心脏病患者的一生都面临着长期的挑战,这些挑战尚未被完全了解,仍在不断发展。医疗保健的重新设计需要彻底了解这一旅程,以便创建和实施改善结果的解决方案。本研究绘制了单心室先天性心脏病患者及其家庭的一生旅程图,确定了对他们最有意义的结果,并定义了旅程中的重大挑战。
方法和结果 本定性研究包括经验组会议和患者、父母、兄弟姐妹、伴侣和利益相关者的 1:1 访谈。绘制了旅程图。确定了患者和家长一生中最有意义的结果以及护理中的重大差距。共有来自 79 个家庭的 142 名参与者和 28 名利益相关者参加了此次研究。绘制了终生和生命阶段特定的旅程图。使用“”框架确定并分类了患者和家长最有意义的结果。确定并分类了护理中的差距,分为沟通效果不佳、缺乏无缝过渡、缺乏全面支持、结构缺陷和教育不足等领域。
结论 在患有单心室先天性心脏病患者及其家庭的一生旅程中,护理存在重大差距。彻底了解这一旅程是围绕他们的需求和优先事项重新设计护理的第一步,对于其他形式的先天性心脏病和其他慢性疾病的患者也同样适用。