Institute of Health and Care Sciences, University of Gothenburg, Goteborg, Sweden
Region Västra Götaland, Children's Heart Center, Sahlgrenska University Hospital, Goteborg, Sweden.
BMJ Open. 2024 Aug 17;14(8):e079996. doi: 10.1136/bmjopen-2023-079996.
Young people with congenital heart disease (CHD) are frequently affected by discontinued follow-up when transferring from paediatric to adult care. Identified predictors for discontinuation include mostly patient-related factors, and further knowledge of hospital and healthcare system factors is needed.
This study aims to explore patient-related, hospital-related and healthcare system-related factors affecting continued follow-up care after transfer, as perceived and experienced by paediatric cardiology and adult CHD (ACHD) healthcare providers (HCPs) in Sweden and Belgium.
This descriptive qualitative study included individual interviews with cardiologists, nurses and administrative staff, subjected to qualitative content analysis. A total of 30 HCPs from 13 specialist care outpatient clinics at 8 different centres in Sweden and Belgium were interviewed. HCPs were included if they had direct contact with patients and had at least 1 year of work experience.
The findings illuminate three main categories of factors perceived by HCPs to affect continued follow-up care after transfer, including 'care structure', 'care processes' and 'patient characteristics and circumstances'. Success was described as multifactorial, emphasising processes and structures of care, with a focus on collaboration, organisation, joint responsibility, resources, care relationships and transitional care interventions. Few differences appeared between paediatric and ACHD HCPs and between Swedish and Belgian HCPs.
HCPs perceived factors on patient, hospital and healthcare system levels to influence continued follow-up. Process-related and structure-related aspects of care were perceived as more influential than individual patient characteristics. Hence, future research on discontinued follow-up care should focus on process-related and structure-related aspects of care delivery.
年轻人患有先天性心脏病（CHD）时，在从儿科过渡到成人护理时，经常会出现随访中断的情况。已确定的中断预测因素主要包括患者相关因素，需要进一步了解医院和医疗保健系统的因素。
本研究旨在探讨瑞典和比利时儿科心脏病学和成人先天性心脏病（ACHD）医疗保健提供者（HCP）认为和体验到的影响转移后继续接受随访护理的患者相关、医院相关和医疗保健系统相关因素。
这是一项描述性定性研究，包括对来自瑞典和比利时 8 个不同中心的 13 个专科门诊的 30 名心脏病专家、护士和行政人员进行的个体访谈，进行定性内容分析。入选标准为：与患者有直接接触且至少有 1 年工作经验的 HCP。
研究结果阐明了 HCP 认为影响转移后继续接受随访护理的三个主要类别因素，包括“护理结构”、“护理过程”和“患者特征和情况”。成功被描述为多因素的，强调护理的过程和结构，重点是合作、组织、共同责任、资源、护理关系和过渡护理干预。儿科和 ACHD HCP 以及瑞典和比利时 HCP 之间的差异很少。
HCP 认为患者、医院和医疗保健系统层面的因素会影响继续接受随访。HCP 认为与护理过程和结构相关的因素比个体患者特征更具影响力。因此，未来关于中断随访护理的研究应侧重于护理提供的过程相关和结构相关方面。
