New Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Stenbackinkatu 9, 00290, Helsinki, Finland.
Kuopio University Hospital, Primary Health Care Unit Kuopio, Pohjois-Savo, Finland.
Pediatr Rheumatol Online J. 2023 Dec 21;21(1):149. doi: 10.1186/s12969-023-00938-0.
With chronic diseases, the responsibility for care transfers to adult clinics at some point. Juvenile idiopathic arthritis (JIA) is the most common persistent rheumatic condition in children. A successful transition requires sufficient self-management skills to manage one´s chronic condition and all the tasks involved. In this study, we evaluated transition readiness in Finnish patients with JIA. We aimed to find practical tools to support a successful transition and to study the possible consequences of an unsuccessful transition.
The usefulness of a specific questionnaire, which was administered to 83 JIA patients, was evaluated in this study. We also gathered information from their first adult clinic visit to assess the success of their transition and its relation to disease activity.
In 55 (71%) patients, the transition was estimated to be successful. We were able to determine a cut-off score in the questionnaire for a successful transition: the best estimate for a successful transition is when the score is 24 or more. At the first adult clinic visit, an unsuccessful transition was evident in its effect on disease outcome. If the transition was defined as successful, the DAS28 was better.
We found the questionnaire to be a useful tool for evaluating transition readiness. Determination of a successful transition helped us identify those adolescents who needed more profound support to improve their self-management skills and thus enhance their transition process. An unsuccessful transition was shown to negatively impact on disease outcomes.
随着慢性病的发展,患者在某个时间点需要将护理责任转移到成人诊所。幼年特发性关节炎(JIA)是儿童中最常见的持续性风湿性疾病。成功的过渡需要有足够的自我管理技能来管理慢性疾病及其所有相关任务。在这项研究中,我们评估了芬兰 JIA 患者的过渡准备情况。我们旨在寻找实用的工具来支持成功的过渡,并研究不成功过渡的可能后果。
本研究评估了专门问卷在 83 名 JIA 患者中的实用性。我们还从他们的第一次成人诊所就诊中收集信息,以评估过渡的成功及其与疾病活动的关系。
在 55 名(71%)患者中,过渡被评估为成功。我们能够确定问卷中用于成功过渡的截止分数:成功过渡的最佳估计值是分数为 24 或更高。在第一次成人诊所就诊时,过渡的不成功明显影响了疾病结果。如果将过渡定义为成功,则 DAS28 更好。
我们发现该问卷是评估过渡准备情况的有用工具。确定成功过渡有助于我们识别那些需要更多支持来提高自我管理技能从而增强过渡过程的青少年。不成功的过渡被证明对疾病结果有负面影响。