Soma Katsura, Ochiai Ryota, Tsutsui Hiroyuki, Takeda Norihiko, Yao Atsushi
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo Tokyo Japan.
Adult Nursing, Department of Nursing, School of Medicine, Yokohama City University Yokohama Japan.
Circ Rep. 2024 May 15;6(6):209-216. doi: 10.1253/circrep.CR-24-0016. eCollection 2024 Jun 10.
Individuals transitioning into adulthood require age-appropriate medical care and delegation of decision-making authority from their parents to the patients themselves. Although there have been multiple observational and interventional studies on transitional care for patients with congenital heart disease (CHD) in the cardiovascular field, transitional care specific to childhood-onset cardiomyopathy (CM) remains unaddressed. A nationwide questionnaire-based survey was performed in the pediatric cardiology departments of 151 facilities in Japan. Responses were obtained from 100 (66%) facilities with low transfer rates (<5%) for childhood-onset CM cases. The comparison between CHD-transferring and non-CHD-transferring facilities revealed a significantly higher transfer rate (83.9%) for childhood-onset CM cases in the CHD-transferring facilities (P<0.001). Regarding the transition programs, 72 (72%) facilities do not offer any programs for CM, while most (92%) facilities recognize its necessity. Finally, only 19 (19%) facilities provided a transition program, 10 of which were CHD based. To the best of our knowledge, this is the first study to demonstrate the poor transition/transfer care status of patients with childhood-onset CM in Japan. The transfer rate of CMs was lower than that of CHDs, and transition programs were less available. Referring to the system established for CHD could help develop a successful transitional care system for CM.
步入成年期的个体需要获得与其年龄相适应的医疗护理,并将决策权从父母下放给患者本人。尽管心血管领域针对先天性心脏病(CHD)患者的过渡性护理已经开展了多项观察性和干预性研究,但针对儿童期起病的心肌病(CM)的过渡性护理仍未得到解决。我们在日本151家机构的儿科心脏病科进行了一项基于问卷调查的全国性调查。从100家(66%)儿童期起病的CM病例转诊率较低(<5%)的机构获得了回复。CHD转诊机构与非CHD转诊机构之间的比较显示,CHD转诊机构中儿童期起病的CM病例转诊率显著更高(83.9%)(P<0.001)。关于过渡项目,72家(72%)机构没有提供任何针对CM的项目,而大多数(92%)机构认识到其必要性。最后,只有19家(19%)机构提供了过渡项目,其中10个是以CHD为基础的。据我们所知,这是第一项证明日本儿童期起病的CM患者过渡/转诊护理状况不佳的研究。CM的转诊率低于CHD,过渡项目也较少。参考为CHD建立的系统有助于为CM开发成功的过渡性护理系统。