Killackey Tieghan, Nishat Fareha, Elsman Ellen, Lawson Erica, Kelenc Lauren, Stinson Jennifer N
School of Nursing, Faculty of Health, York University, Toronto, Canada.
Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.
Health Care Transit. 2023 Oct 12;1:100022. doi: 10.1016/j.hctj.2023.100022. eCollection 2023.
The transition from pediatric to adult care settings for adolescents and young adults living with chronic conditions can be challenging and has been associated with declines in health and access to care. Well-validated measures of patients' transition readiness are critical, both for use in the clinical setting and to rigorously evaluate transition support programs for the purposes of research and health care quality improvement.
This review aimed to build off existing reviews and 1) identify and describe all newly developed and validated measures for the assessment of transition readiness for youth with chronic illness from the period of 2018-2022, and 2) evaluate their measurement properties and identify gaps in measurement testing.
Electronic searches were conducted in MEDLINE, EMBASE, CINAHL and PsychINFO to identify articles developing and validating transition readiness in individuals aged 12-26 years with a chronic illness between 2018 and 2022. Two reviewers independently selected articles for review and assessed quality of measurement properties.
22 studies met inclusion criteria reporting on 21 different tools. 9 studies reported on the development and evaluation of a new tool, and 13 reported on the adaptation, modification, and/or translation of an existing tool. Most adapted tools were translations and adaptations of the Transition Readiness Assessment Questionnaire (TRAQ) (n = 7). While some of these studies demonstrated sufficient internal consistency and structural validity, few met the COSMIN criteria for reliability and hypothesis testing and none met the criteria for cross-cultural validity. Criterion validity and measurement error were not assessed in any studies.
Many new transition readiness measures continue to be developed in recent years, yet few have undergone rigorous psychometric evaluation. The TRAQ was the existing measure most often used as a model for developing new or modified tools. There remains a clear need for further validation of existing measures of patients' readiness to transition as opposed to continuing to develop new measures.
慢性病青少年和青年从儿科护理环境过渡到成人护理环境可能具有挑战性，且与健康状况下降和获得医疗服务的机会减少有关。经过充分验证的患者过渡准备情况衡量指标至关重要，既适用于临床环境，也可用于严格评估过渡支持项目，以进行研究和改善医疗质量。
本综述旨在基于现有综述进行拓展，1）识别并描述2018年至2022年期间所有新开发并验证的用于评估慢性病青年过渡准备情况的指标，2）评估其测量属性并识别测量测试中的差距。
在MEDLINE、EMBASE、CINAHL和PsychINFO中进行电子检索，以识别2018年至2022年期间开发和验证12至26岁慢性病患者过渡准备情况的文章。两名评审员独立选择文章进行评审，并评估测量属性的质量。
22项研究符合纳入标准，报告了21种不同的工具。9项研究报告了新工具的开发和评估，13项研究报告了现有工具的改编、修改和/或翻译。大多数改编工具是《过渡准备评估问卷》（TRAQ）的翻译和改编版本（n = 7）。虽然其中一些研究显示出足够的内部一致性和结构效度，但很少有研究符合COSMIN可靠性和假设检验标准，没有一项符合跨文化效度标准。任何研究均未评估效标效度和测量误差。
近年来继续开发了许多新的过渡准备情况衡量指标，但很少经过严格的心理测量学评估。TRAQ是最常被用作开发新工具或修改工具模型的现有指标。显然仍需要进一步验证现有患者过渡准备情况指标，而不是继续开发新指标。
