Sarmiento Cristina A, Wyrwa Jordan M, Glaros Chloe, Holliman Brooke Dorsey, Brenner Lisa A
Department of Physical Medicine and Rehabilitation, Division of Pediatric Rehabilitation Medicine, University of Colorado Anschutz School of Medicine, Aurora, CO, USA.
Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado Anschutz School of Medicine, Aurora, CO, USA.
Dev Med Child Neurol. 2025 Jan;67(1):99-110. doi: 10.1111/dmcn.15907. Epub 2024 Mar 24.
To increase understanding regarding the experiences and values of young adults with cerebral palsy (CP), and their caregivers, regarding pediatric rehabilitation-related care, including perceived barriers and potential facilitators to transition to adult care.
This was a qualitative descriptive study that used 20 semi-structured interviews (13 caregivers and seven patient-caregiver dyads).
We identified four major themes: (1) the value and security of long-term relationships; (2) feeling 'rudderless' navigating the logistics of transition; (3) differences in pediatric versus adult models of care; and (4) perceived lack of provider expertise and comfort in adult care settings. Young adults with CP who had not yet transitioned to adult rehabilitation care and their caregivers placed high value on provider relationships and expertise, advanced planning, communication, and coordination of care.
Identified barriers and potential facilitators to the transition to adult rehabilitation care reflected the uncertainty that accompanies leaving an established healthcare relationship. Challenges related to the logistics of this transition, differences in models of care, and perceived lack of provider comfort and expertise in adult care settings were also noted. Our findings could be used to develop and study patient-centered and family-centered transition processes for individuals with CP to promote age-appropriate and developmentally appropriate lifespan care.
增进对患有脑瘫(CP)的年轻人及其照顾者在儿科康复相关护理方面的经历和价值观的理解,包括感知到的向成人护理过渡的障碍和潜在促进因素。
这是一项定性描述性研究,采用了20次半结构化访谈(13名照顾者和7对患者 - 照顾者二元组)。
我们确定了四个主要主题:(1)长期关系的价值和安全感;(2)在过渡的后勤安排中感到“无方向”;(3)儿科护理模式与成人护理模式的差异;(4)在成人护理环境中感知到提供者缺乏专业知识和舒适度。尚未过渡到成人康复护理的患有CP的年轻人及其照顾者高度重视提供者关系和专业知识、提前规划、沟通以及护理协调。
确定的向成人康复护理过渡的障碍和潜在促进因素反映了离开既定医疗关系所伴随的不确定性。还指出了与这种过渡的后勤安排、护理模式差异以及在成人护理环境中感知到提供者缺乏舒适度和专业知识相关的挑战。我们的研究结果可用于为患有CP的个体开发和研究以患者为中心和以家庭为中心的过渡过程,以促进适合年龄和发育阶段的终生护理。