Burger Debora, Denfeld Quin E, Uzark Karen, Evers Patrick D, McHill Andrew W, Ward Pam, Hasan Reem
Oregon Health & Science University, School of Nursing, Portland, OR, USA.
Oregon Health & Science University, Knight Cardiovascular Institute, Portland, OR, USA.
Health Care Transit. 2024 Jan 18;2:100042. doi: 10.1016/j.hctj.2024.100042. eCollection 2024.
Formal transition programs prepare pediatric patients with congenital heart disease (CHD) for successful lifelong management of their disease. Conducting transition program activities in pediatric cardiology clinics can be a challenge if there are limited resources. The purpose of this study was to test the effectiveness of a medical assistant (MA)-facilitated transition activity in increasing documentation of transition discussions and characterize staff acceptability of this intervention.
We performed a prospective exploratory study over a five-week period. CHD patients aged 13 and older presenting for routine pediatric cardiology follow-up appointments received a prompt from the MA to view a list of 17 transition topics from which to choose topics for discussion with the pediatric cardiologist during the clinic visit. Historical control group data were collected from the same period, two years prior. We compared the presence of documentation of transition discussions between the transition activity and control group using comparative statistics. Staff acceptability was assessed using the revised Treatment Acceptability and Preference Questionnaire.
A total of 14 staff members participated in the transition activity involving 29 patients. Significantly more transition discussions were documented in the transition activity group compared with the historic control group ( < 0.001). Patients discussed more transition topics (median = 5, Interquartile range 2-7) than what was requested (median = 2, Interquartile range 1-4). All staff rated the activity as acceptable (ranging from 'somewhat acceptable' to 'very much acceptable') and were willing to continue after the study ended.
Having an MA-facilitated transition activity increased documentation of transition discussions in the pediatric cardiology clinic. Staff were accepting and in favor of continuing this low-resource activity.
正规的过渡计划能让患有先天性心脏病（CHD）的儿科患者为其疾病的终身成功管理做好准备。如果资源有限，在儿科心脏病诊所开展过渡计划活动可能会面临挑战。本研究的目的是测试由医疗助理（MA）推动的过渡活动在增加过渡讨论记录方面的有效性，并描述工作人员对该干预措施的接受程度。
我们在五周内进行了一项前瞻性探索性研究。13岁及以上前来进行常规儿科心脏病随访预约的CHD患者收到了医疗助理的提示，可查看一份包含17个过渡主题的列表，从中选择在诊所就诊期间与儿科心脏病专家讨论的主题。历史对照组数据收集自两年前的同一时期。我们使用比较统计方法比较了过渡活动组和对照组之间过渡讨论记录的存在情况。使用修订后的治疗可接受性和偏好问卷评估工作人员的接受程度。
共有14名工作人员参与了涉及29名患者的过渡活动。与历史对照组相比，过渡活动组记录的过渡讨论明显更多（<0.001）。患者讨论的过渡主题（中位数 = 5，四分位间距2 - 7）比要求的更多（中位数 = 2，四分位间距1 - 4）。所有工作人员都认为该活动是可接受的（从“有点可接受”到“非常可接受”），并愿意在研究结束后继续开展。
开展由医疗助理推动的过渡活动增加了儿科心脏病诊所过渡讨论的记录。工作人员接受并支持继续开展这项资源需求较低的活动。
