1Department of Neurosurgery, University Hospital of Basel.
2Division of Pediatric Neurosurgery, University Children's Hospital Basel; and.
Neurosurg Focus. 2024 Aug 1;57(2):E15. doi: 10.3171/2024.5.FOCUS24232.
Transitional care in pediatric neurosurgery is challenging for patients and their parents. The specific needs of neurologically affected patients and the unique characteristics of the pathologies affecting pediatric neurosurgical patients compared with adults make a comprehensive, well-organized transition process essential for patient well-being and ensuring continuity of care. Little is known about patients' preferences and opinions on this topic. This study aimed to assess the patients' and parents' expectations and perceptions of the transition process.
The authors retrospectively identified patients aged 16 to 30 years who underwent surgery in their pediatric neurosurgical department. The patients were divided into two groups: those about to transition and those who had already transitioned. Transition models were identified within the latter group. Parents of eligible patients were contacted for a telephone survey, and the patients themselves were included when possible. A modified version of the established Got Transition questionnaire from the National Alliance to Advance Adolescent Health was used.
Thirty-four patients were included, and 44 telephone surveys were conducted with the patients and their parents. Three transition models were applied, with 7 patients (41.2%) transitioned using the continued caregiver model, 9 patients (52.9%) using the shared caregiver model, and 1 patient (5.9%) using the specialized clinic model. Patient and parent satisfaction was highest among the patients transitioned using the continued caregiver and specialized clinic models.
Neurosurgical conditions in children differ significantly from those in adults, creating unique transitional care challenges. The continuing caregiver model has been shown to provide continuity of care and high patient and parent satisfaction. However, there are differences in the perspectives of parents and patients regarding transitional care, with parents typically expressing greater concern and need for detailed information. Implementing a well-structured and individualized transition process is essential to reduce the caregiving burden on families and healthcare institutions.
儿科神经外科的过渡护理对患者及其父母来说具有挑战性。与成人相比,神经功能受损患者的特殊需求以及影响儿科神经外科患者的疾病的独特特征使得全面、组织良好的过渡过程对于患者的健康和确保护理连续性至关重要。关于这个话题,人们对患者的偏好和意见知之甚少。本研究旨在评估患者和家长对过渡过程的期望和看法。
作者回顾性地确定了在他们的儿科神经外科部门接受手术的 16 至 30 岁的患者。这些患者被分为两组:即将过渡的患者和已经过渡的患者。在后者组中确定了过渡模型。联系符合条件的患者的家长进行电话调查,并且在可能的情况下包括患者本人。使用国家青少年健康联盟(National Alliance to Advance Adolescent Health)建立的经过修改的既定 Got Transition 问卷。
共纳入 34 例患者,对 44 例患者及其家长进行了电话调查。应用了三种过渡模式,7 例患者(41.2%)采用持续护理者模式过渡,9 例患者(52.9%)采用共享护理者模式过渡,1 例患者(5.9%)采用专门诊所模式过渡。采用持续护理者和专门诊所模式过渡的患者和家长满意度最高。
儿童的神经外科疾病与成人有很大的不同,这就产生了独特的过渡护理挑战。持续护理者模式已被证明可以提供连续性护理,并使患者和家长高度满意。然而,家长和患者对过渡护理的看法存在差异,家长通常更关心并需要详细信息。实施结构良好且个性化的过渡过程对于减轻家庭和医疗机构的照顾负担至关重要。