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移民青少年向成人医疗保健的过渡:实践建议。

Transition to adult healthcare for immigrant youth: Practice recommendations.

作者信息

Mackie Andrew S, Tulli-Shah Mia, Chappell Alyssa, Kariwo Michael, Ibrahim Siciida, Salami Bukola

机构信息

Department of Pediatrics, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada.

Faculty of Nursing, University of Alberta, Faculty of Nursing, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada.

出版信息

Health Care Transit. 2024 Nov 5;2:100079. doi: 10.1016/j.hctj.2024.100079. eCollection 2024.

Abstract

INTRODUCTION

The transition from pediatric to adult healthcare is challenging for adolescents and young adults (AYA) with pediatric-onset chronic health conditions. Although barriers faced by AYA during transition are well-documented, previous studies have not considered how migration and settlement impact patient and family experiences.

OBJECTIVES

To fill this gap, we conducted a qualitative descriptive study to explore the recommendations for policy and practice from the perspectives of immigrant and refugee AYA living with chronic health conditions in Canada as they transition from pediatric to adult healthcare. We also sought the perspectives of their parents/caregivers and service providers.

METHODS

Semi-structured individual interviews and focus groups were conducted with 20 AYA, 14 caregivers, and 5 service providers. AYA were 1st or 2nd generation immigrants to Canada, aged 16-25, with childhood-onset chronic health conditions. Parents or caregivers were 1st generation immigrants, having children with chronic health conditions. Service providers delivered healthcare or other services to immigrant populations.

RESULTS

Recommendations to improve the transition process and mitigate barriers to care included providing more accessible information about patients' health conditions prior to transition, moving the age of transfer beyond age 18, establishing a centralized online health portal for patients who are transitioning to the adult system, providing family case workers, increasing language support, and increasing cross-sector support.

CONCLUSION

A broad range of recommendations aimed at improving the transition process were provided. Future interventions to support transition from pediatric to adult care for immigrants and refugees should incorporate these recommendations.

摘要

引言

对于患有儿童期慢性健康问题的青少年和青年(AYA)而言,从儿科医疗向成人医疗的过渡颇具挑战。尽管AYA在过渡期间面临的障碍已有详尽记录,但此前的研究尚未考虑移民和定居如何影响患者及其家庭的经历。

目的

为填补这一空白,我们开展了一项定性描述性研究,以从加拿大患有慢性健康问题的移民和难民AYA从儿科医疗过渡到成人医疗的角度,探索对政策和实践的建议。我们还征求了他们的父母/照顾者以及服务提供者的意见。

方法

对20名AYA、14名照顾者和5名服务提供者进行了半结构化个人访谈和焦点小组访谈。AYA为加拿大第一代或第二代移民,年龄在16至25岁之间,患有儿童期慢性健康问题。父母或照顾者为第一代移民,其子女患有慢性健康问题。服务提供者为移民群体提供医疗或其他服务。

结果

改善过渡过程和减轻护理障碍的建议包括在过渡前提供更多关于患者健康状况的易获取信息、将转诊年龄提高到18岁以上、为过渡到成人系统的患者建立一个集中的在线健康门户、提供家庭个案工作者、增加语言支持以及增加跨部门支持。

结论

提供了一系列旨在改善过渡过程的建议。未来支持移民和难民从儿科护理过渡到成人护理的干预措施应纳入这些建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f10/11658134/607790fd6c4f/ga1.jpg

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