Department of Nursing, Asan Medical Center, Seoul, Republic of Korea.
College of Nursing, the Catholic University of Korea, Seoul, Republic of Korea.
J Pediatr Nurs. 2024 May-Jun;76:38-44. doi: 10.1016/j.pedn.2024.01.033. Epub 2024 Feb 14.
The purpose of this study was to examine the effects of psychological separation and health locus of control on the health care transition readiness of adolescents and young adults (AYAs) with type 1 diabetes.
Data were collected between December 2020 and October 2021. One hundred twelve AYAs with type 1 diabetes treated at a tertiary hospital and under follow-up observation as well as AYAs with type 1 diabetes nationwide who were part of the type 1 diabetes internet community were enrolled. The Psychological Separation Inventory, the Multidimensional Health Locus of Control scale from C, and the Self-management and Transition to Adulthood with Therapeutics = Rx Questionnaire were used.
Multiple regression analysis indicated that age (β = 0.302, p = .001), hemoglobin A1c (HbA1c) (β = -0.174, p = .040), conflictual separation (β = 0.242, p = .005), functional separation (β = 0.200, p = .045) and attitudinal separation (β = -0.240 p = .015) were significantly associated with health management transition readiness; these predictors explained 27.6% of health care transition readiness (F = 8.062, p = .000).
AYAs with type 1 diabetes can enhance readiness for health care transition by fostering psychological separation from parents, effectively managing blood glucose levels, and taking into account age-related factors during the preparation process. At this point, it is essential for healthcare professionals to guide parents in recognizing adolescents' psychological independence and facilitating their supportive role through the process of redefining their roles.
Health care providers should promote psychological separation in AYAs. Additionally, taking into account the developmental characteristics of adolescence can facilitate a successful health care transition.
本研究旨在探讨心理分离和健康控制源对 1 型糖尿病青少年和年轻成人(AYA)的医疗过渡准备情况的影响。
数据收集于 2020 年 12 月至 2021 年 10 月期间。研究纳入了在一家三级医院接受治疗并正在接受随访观察的 112 名 1 型糖尿病 AYA 患者,以及全国范围内参与 1 型糖尿病互联网社区的 1 型糖尿病 AYA 患者。研究采用了心理分离量表、C 多维健康控制源量表和自我管理与成年过渡期治疗问卷。
多元回归分析表明,年龄(β=0.302,p=.001)、糖化血红蛋白(HbA1c)(β=-0.174,p=.040)、冲突性分离(β=0.242,p=.005)、功能性分离(β=0.200,p=.045)和态度性分离(β=-0.240,p=.015)与健康管理过渡准备情况显著相关;这些预测因素解释了医疗过渡准备情况的 27.6%(F=8.062,p=.000)。
通过促进与父母的心理分离、有效管理血糖水平,并在准备过程中考虑与年龄相关的因素,1 型糖尿病 AYA 可以增强其医疗过渡准备情况。此时,医疗保健专业人员引导父母认识到青少年的心理独立性,并在重新定义角色的过程中为他们提供支持是至关重要的。
医疗保健提供者应促进 AYA 的心理分离。此外,考虑到青春期的发展特点可以促进医疗过渡的成功。