Overbury Rebecca S, Eddington Devin, Sward Katherine, Hersh Aimee
Division of Rheumatology, Department of Internal Medicine, Adjunct Assistant Professor, Division of Pediatric Rheumatology, Department of Pediatrics, University of Utah, School of Medicine, 30 N Mario Capecchi Drive, Salt Lake City, UT 84112, United States.
Division of Epidemiology, Department of Internal Medicine, University of Utah, School of Medicine, Salt Lake City, UT, United States.
Health Care Transit. 2025 Jan 16;3:100094. doi: 10.1016/j.hctj.2024.100094. eCollection 2025.
To better define components of successful Health Care Transition (HCT) we surveyed patients in an academic Rheumatology Transition clinic at the University of Utah. Results can be used to improve HCT over time.
We asked patients and parents to complete Mind the Gap and the Transition Feedback survey as part of a larger registry dataset collected from said Rheumatology Transition clinic. Results from Mind the Gap and the Transition Feedback survey were analyzed. Survey responses are presented as averages.
Sixty-five patients and 42 parents completed Mind the Gap. Patients report that the clinic is outperforming their expectations in 20 of 22 variables. Parents report that the clinic is underperforming their expectations in 23 of 27 variables. Parents value these 22 variables more than the patients. Twenty-four patients and 15 parents completed the Transition Feedback survey. More than 50 % of patients and parents state that the components of HCT curriculum were addressed. 58 % of patients (14 out of 24) reported feeling "very ready" to move to an adult doctor or other health care provider. 53 % of parents (8 out of 15) felt their child was "very ready" to move to an adult doctor or other health care provider.
A difficulty in defining a successful transfer is how to simultaneously integrate the perspective and needs of the patient and parents. This research shows that the values of patients and their parents generally align. However, there are important disparities between these groups. We demonstrate that even in a dedicated Transition clinic, not all components of HCT are being administered and that only half of patients and parents feel prepared to transfer.
为了更好地界定成功的医疗保健过渡（HCT）的组成部分，我们对犹他大学学术性风湿病过渡诊所的患者进行了调查。随着时间的推移，研究结果可用于改善HCT。
作为从上述风湿病过渡诊所收集的更大登记数据集的一部分，我们要求患者和家长完成“注意差距”和过渡反馈调查。对“注意差距”和过渡反馈调查的结果进行了分析。调查回复以平均值呈现。
65名患者和42名家长完成了“注意差距”调查。患者报告称，诊所在22个变量中的20个方面表现超出他们的预期。家长报告称，诊所在27个变量中的23个方面表现未达他们的预期。家长比患者更看重这22个变量。24名患者和15名家长完成了过渡反馈调查。超过50%的患者和家长表示，HCT课程的组成部分得到了涵盖。58%的患者（24名中的14名）报告称“非常准备好”转至成人医生或其他医疗服务提供者处。53%的家长（15名中的8名）认为他们的孩子“非常准备好”转至成人医生或其他医疗服务提供者处。
界定成功过渡的一个难点在于如何同时整合患者和家长的观点及需求。本研究表明，患者及其家长的价值观总体上是一致的。然而，这些群体之间存在重要差异。我们证明，即使在专门的过渡诊所，HCT的并非所有组成部分都得到了落实，而且只有一半的患者和家长觉得为转诊做好了准备。
