Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, QC, Canada.
Département de pédiatrie (section médecine de l'adolescence), Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada.
Int J Qual Stud Health Well-being. 2023 Dec;18(1):2278904. doi: 10.1080/17482631.2023.2278904. Epub 2023 Nov 23.
Transition from paediatric to adult care is challenging for youths with a chronic condition. Most transition programmes place high value in autonomy and independence. We undertook a qualitative study to: (1) identify the needs and aspirations of youths and (2) better understand the well-being and flourishing of youths.
Semi-structured interviews were conducted with youths, parents of youths and healthcare professionals recruited from four clinics. Thematic analysis focused on: (1) perceptions of transition; (2) key aspects of human flourishing during transition; and (3) salient concerns with respect to the transition and dimensions of human flourishing.
54 interviews were conducted. Perceptions of transition clustered around: (1) apprehension about adult care; (2) lack of clarity about the transition process; (3) emotional attachment to paediatric healthcare professionals; (4) the significance of the coinciding transition into adulthood. Fourteen salient concerns (e.g., Knowledge and information about the transition, Parental involvement in healthcare) were identified with corresponding recommendations. Salient concerns related to important dimensions of human flourishing (e.g., environmental mastery, autonomy).
The flourishing of youths is affected by suboptimal transition practices. We discuss the implications of our findings for environmental mastery, contextual autonomy, and the holistic and humanistic aspects of transition.
对于患有慢性疾病的青少年来说,从儿科护理过渡到成人护理具有挑战性。大多数过渡项目都非常重视自主权和独立性。我们进行了一项定性研究,以:(1)确定青少年的需求和愿望;(2)更好地了解青少年的幸福和繁荣。
从四个诊所招募青少年、青少年的父母和医疗保健专业人员进行半结构化访谈。主题分析侧重于:(1)对过渡的看法;(2)过渡期间人类繁荣的关键方面;(3)对过渡和人类繁荣维度的突出关注。
进行了 54 次访谈。对过渡的看法集中在:(1)对成人护理的担忧;(2)对过渡过程缺乏明确性;(3)对儿科医疗保健专业人员的情感依恋;(4)与成年期同时发生的过渡的重要性。确定了 14 个突出的关注点(例如,过渡的知识和信息,父母对医疗保健的参与),并提出了相应的建议。突出的关注点与人类繁荣的重要方面有关(例如,环境掌控、自主性)。
青少年的繁荣受到过渡实践不佳的影响。我们讨论了我们的研究结果对环境掌控、情境自主性以及过渡的整体和人文方面的影响。