Sturm Jobert, van Staa AnneLoes, Escher Johanna C, Sattoe Jane
Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands.
Department of Paediatric Gastroenterology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands.
Health Care Transit. 2024 Aug 30;2:100071. doi: 10.1016/j.hctj.2024.100071. eCollection 2024.
In the Netherlands, the 2022 Quality Standard 'Youth in transition from paediatric to adult care' underscores the importance of structured transitional care for young adults with chronic health conditions. Despite this emphasis, detailed knowledge about transition programs and their successful elements remains sparse. This study aims to bridge this gap by exploring nurse-led transition clinics that had successfully implemented core interventions such as a transition coordinator, warm handover, and individual transition plans.
Employing a mixed-methods approach, this study integrated semi-structured interviews with 15 healthcare professionals from both paediatric and adult care across six transition clinics, and surveys from 54 young adults who had transitioned within the last three years. The 'On Your Own Feet Framework' guided the evaluation of transitional care practices. Thematic analysis was applied to qualitative data, while descriptive and inferential statistics were used to analyse quantitative data.
The study revealed a strong dedication among healthcare professionals to ensuring smooth transitions and effective collaboration between paediatric and adult care. The young adults reported high satisfaction with their transitions, particularly appreciating the continuity of care and the pivotal role of nurses and nurse practitioners as transition coordinators. However, challenges such as engaging young adults, resource allocation, and financial complexities were noted, alongside areas for improvement including shared decision-making and managing parental involvement. Motivation and collaboration among staff were identified as facilitating factors.
Our findings emphasize the vital role of nurse-led transition clinics in enhancing healthcare transitions for young adults in the Netherlands, aligning with the principles outlined in the Quality Standard and the On Your Own Feet Framework. While high satisfaction levels with current practices suggest a positive impact, they also highlight that ongoing improvement and adaptation are needed to overcome identified challenges. Successful healthcare transition requires a comprehensive, collaborative approach involving patients, families, and healthcare professionals, supported by organizational and systemic frameworks. This study contributes to a nuanced understanding of transitional care, suggesting a path forward for integrating these practices into standard care models.
在荷兰，2022年的《从儿科护理过渡到成人护理的青年质量标准》强调了为患有慢性健康状况的青年提供结构化过渡护理的重要性。尽管有此强调，但关于过渡项目及其成功要素的详细知识仍然匮乏。本研究旨在通过探索成功实施了诸如过渡协调员、温暖交接和个人过渡计划等核心干预措施的护士主导的过渡诊所来填补这一空白。
本研究采用混合方法，对来自六个过渡诊所的15名儿科和成人护理领域的医疗保健专业人员进行了半结构化访谈，并对过去三年中完成过渡的54名青年进行了调查。“自立框架”指导了对过渡护理实践的评估。对定性数据进行了主题分析，同时使用描述性和推断性统计分析定量数据。
研究表明，医疗保健专业人员致力于确保顺利过渡以及儿科和成人护理之间的有效协作。青年对他们的过渡表示高度满意，尤其赞赏护理的连续性以及护士和执业护士作为过渡协调员的关键作用。然而，研究指出了诸如吸引青年参与、资源分配和财务复杂性等挑战，以及包括共同决策和管理家长参与等需要改进的领域。工作人员之间的积极性和协作被确定为促进因素。
我们的研究结果强调了护士主导的过渡诊所在改善荷兰青年的医疗保健过渡方面的重要作用，这与质量标准和“自立框架”中概述的原则一致。虽然对当前实践的高满意度表明有积极影响，但也突出表明需要持续改进和调整以克服已确定的挑战。成功的医疗保健过渡需要一种全面、协作的方法，涉及患者、家庭和医疗保健专业人员，并得到组织和系统框架的支持。本研究有助于对过渡护理有更细致入微的理解，为将这些实践纳入标准护理模式指明了前进的道路。
