Institute of Liver Studies, King's College Hospital, London, UK.
Paediatric Liver, Gastroenterology & Nutrition Centre, King's College Hospital, London, UK.
Pediatr Transplant. 2023 Dec;27(8):e14614. doi: 10.1111/petr.14614. Epub 2023 Oct 8.
We aimed to assess self-management skills and adherence behaviors in young people post-liver transplant and compare these with those of young people with autoimmune liver disease and other forms of chronic liver disease.
As part of our specialist multidisciplinary clinic, n = 156 young people (aged 16-25 years) completed the Liver Self-Management Questionnaire (an adaptation of the Developmentally Based Skills Checklist for adolescents post-liver transplant and modified for us across liver disease type and within the United Kingdom). Those taking medication (n = 128) also completed a service-designed questionnaire regarding adherence. The statistical significance of group differences was assessed with non-parametric analyses.
Young people post-liver transplant were less likely to report managing their condition independently than those with autoimmune liver disease or those with other forms of chronic liver disease. They also reported higher adherence (93%) compared to those with autoimmune liver disease (77%) and those with other forms of chronic liver disease (85%). However, the vast majority of self-management and adherence behaviors were comparable between young people post-transplant and those with autoimmune liver disease/other forms of chronic liver disease.
Our data are in line with existing data from US samples and also extend these findings to include those with other forms of chronic liver disease. These data highlight the importance of individualized care for young adults, regardless of condition type or healthcare setting, and of clinicians managing their expectations regarding what is considered appropriate condition management in early adulthood.
我们旨在评估肝移植后青少年的自我管理技能和依从行为,并将其与自身免疫性肝病和其他形式的慢性肝病患者进行比较。
作为我们专科多学科诊所的一部分,n=156 名年轻人(年龄 16-25 岁)完成了肝脏自我管理问卷(一种针对青少年肝移植后的基于发育的技能清单的改编版,根据肝病类型和英国国内情况进行了修改)。那些正在服用药物的人(n=128)还完成了一份关于依从性的服务设计问卷。使用非参数分析评估组间差异的统计学意义。
与自身免疫性肝病或其他形式的慢性肝病患者相比,肝移植后的年轻人更不可能独立管理自己的病情。与自身免疫性肝病患者(77%)和其他形式的慢性肝病患者(85%)相比,他们的依从性更高(93%)。然而,移植后年轻人的大多数自我管理和依从行为与自身免疫性肝病/其他形式的慢性肝病患者相似。
我们的数据与来自美国样本的现有数据一致,并将这些发现扩展到包括其他形式的慢性肝病患者。这些数据强调了个体化护理对于年轻成年人的重要性,无论其病情类型或医疗保健环境如何,并且还强调了临床医生管理他们对成年早期适当病情管理的期望的重要性。