Intermountain Primary Children's Hospital, Salt Lake City, UT, USA.
Children's Specialty Group, Norfolk, VA, USA.
Pediatr Nephrol. 2025 Jan;40(1):223-230. doi: 10.1007/s00467-024-06497-0. Epub 2024 Sep 6.
A successful transition from pediatric to adult healthcare for adolescent and young adult kidney transplant recipients is essential for maintaining graft and overall health. Readiness for transition is multifactorial and can be challenging to assess. The purpose of this study is to describe the development of a scoring system for a transition readiness assessment for pediatric kidney transplant recipients and assess overall and domain-specific readiness for transition.
This is an observational study of adolescent and young adult kidney transplant recipients over 5 years who were given either the modified Middle (MTRC-m) or modified Late Transition Readiness Checklist (LTRC-m) during post-transplant clinic visits. We developed a scoring system for both checklists and assessed their reliability.
The MTRC-m (38 items) demonstrated good reliability (Cronbach's α = 0.84). The LTRC-m (43 items) demonstrated excellent reliability (Cronbach's α = 0.90). On both the MTRC-m and LTRC-m, patients scored highest on adherence and risky behavior knowledge. Scores were lowest in the "Managing my healthcare needs (self-advocacy)" and "How I feel about myself" domains.
A scored transition assessment allows for rapid appraisal of transition readiness within a clinic setting. We find that participants report high levels of knowledge regarding health-seeking behaviors and risky behaviors, endorse less readiness for managing their care independently, and express a moderate to high degree of worry about their future and their health. While transition programs have traditionally, and necessarily, focused on education, our results demonstrate that programs should expand to also focus on behavior performance and emotional well-being.
青少年和年轻成年肾移植受者成功地从儿科过渡到成人医疗保健对于维持移植物和整体健康至关重要。过渡准备是多因素的，评估具有挑战性。本研究的目的是描述一种儿童肾移植受者过渡准备评估评分系统的开发，并评估整体和特定领域的过渡准备情况。
这是一项对 5 年以上的青少年和年轻成年肾移植受者的观察性研究，他们在移植后门诊就诊时接受了改良中期（MTRC-m）或改良晚期过渡准备检查表（LTRC-m）。我们为两个检查表开发了一个评分系统，并评估了它们的可靠性。
MTRC-m（38 项）表现出良好的可靠性（Cronbach's α=0.84）。LTRC-m（43 项）表现出极好的可靠性（Cronbach's α=0.90）。在 MTRC-m 和 LTRC-m 上，患者在遵医嘱和危险行为知识方面的得分最高。在“管理我的医疗保健需求（自我倡导）”和“我对自己的感觉”两个领域的得分最低。
评分过渡评估允许在诊所环境中快速评估过渡准备情况。我们发现，参与者报告了很高的健康寻求行为和危险行为知识水平，对独立管理自己的护理的准备程度较低，对自己的未来和健康表示中度到高度的担忧。虽然过渡计划传统上且必要地侧重于教育，但我们的结果表明，计划应扩大到还关注行为表现和情绪健康。
