Department of Psychology, McGill University, Montreal, Québec, Canada.
Research Institute of the McGill University Health Centre, Montreal, Québec, Canada.
BMJ Open. 2023 Oct 24;13(10):e076524. doi: 10.1136/bmjopen-2023-076524.
Among youth living with type 1 diabetes (T1D), the increasing demands to diabetes self-care and medical follow-up during the transition from paediatric to adult care has been associated with greater morbidity and mortality. Inadequate healthcare support for youth during the transition care period could exacerbate psychosocial risks and difficulties that are common during emerging adulthood. The current investigation sought to explore the post-transfer perceptions of emerging adults living with T1D relating to their transition to adult care.
Thirty-three emerging adults living with T1D were recruited during paediatric care and contacted for a semistructured interview post-transfer to adult care (16.2±4.2 months post-transfer) in Montreal, Canada. We analysed data using thematic analysis.
We identified four key themes: (1) varied perceptions of the transition process from being quick and abrupt with minimal advice or information from paediatric healthcare providers (HCP) to more positive including a greater motivation for self-management and the transition being concurrent with the developmental period; (2) facilitators to the transition process included informational and tangible social support from HCPs and family or friends, a positive relationship with adult HCP and a greater ease in communicating with the adult care clinic or adult HCP; (3) barriers to adequate transition included lack of advice or information from paediatric HCPs, loss of support from HCPs and friends or family, the separation of healthcare services and greater difficulty in making appointments with adult clinic or HCP and (4) participants recommendations for improving the transition included increasing the length and frequency of appointments in adult care, having access to educational information, and better transition preparation from paediatric HCPs.
The experiences and perceptions of emerging adults are invaluable to guide the ongoing development and improvement of transition programmes for childhood-onset chronic illnesses.
在患有 1 型糖尿病 (T1D) 的青年中，从儿科护理过渡到成人护理期间，对糖尿病自我护理和医疗随访的需求不断增加，这与更高的发病率和死亡率有关。在过渡护理期间，青少年获得的医疗保健支持不足，可能会加剧成年早期常见的心理社会风险和困难。目前的研究旨在探讨患有 T1D 的成年早期个体在过渡到成人护理后的感知。
在加拿大蒙特利尔，从儿科护理中招募了 33 名患有 T1D 的成年早期个体，并在过渡到成人护理后（转移后 16.2±4.2 个月）进行半结构化访谈。我们使用主题分析对数据进行分析。
我们确定了四个关键主题：（1）对过渡过程的看法各不相同，从儿科医疗保健提供者 (HCP) 提供的快速、突然和几乎没有建议或信息，到更积极的看法，包括对自我管理的更大动力和过渡与发展期同时发生；（2）过渡过程的促进因素包括 HCP 和家庭或朋友提供的信息和有形的社会支持、与成年 HCP 的积极关系以及与成人护理诊所或成年 HCP 沟通的更大便利；（3）过渡不足的障碍包括儿科 HCP 缺乏建议或信息、失去 HCP 和朋友或家人的支持、医疗服务的分离以及与成人诊所或 HCP 预约的更大困难；（4）参与者改善过渡的建议包括增加成人护理预约的长度和频率、获得教育信息以及从儿科 HCP 获得更好的过渡准备。
成年早期个体的经验和看法对于指导儿童期起病的慢性病的过渡计划的持续发展和改进非常宝贵。
