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从儿科向成人医疗服务的过渡:一项关于青少年及其父母面临的挑战、需求和偏好的调查。

Transition from pediatric to adult health services: A survey of challenges, needs, and preferences of youths and parents.

作者信息

Racine Eric, Ouimet François, Gutierrez Rojas Rocio Gissel, Clermont Marie-José, Fournier Anne

机构信息

Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, 110 Pine Avenue West, Montréal, QC H2W 1R7, Canada.

Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal, 7101 Parc Avenue, Montréal, QC H3N 1× 9, Canada.

出版信息

Health Care Transit. 2025 Jan 26;3:100095. doi: 10.1016/j.hctj.2025.100095. eCollection 2025.

Abstract

AIM

Transition from pediatric to adult healthcare is a critical period. Recommendations have pointed to greater preparation of youths and families and better coordination. Considerations such as patient values and preferences may - if not taken into consideration - impede uptake of clinical recommendations. This survey-based study aimed to better understand challenges, needs, and intervention preferences of youths and parents during transition.

METHODS

Two online surveys were designed to investigate challenges, needs, and intervention preferences of youths with a chronic or rare condition and parents during transition. The youth survey included the French translation of the Transition Readiness Assessment Questionnaire (TRAQ). Additional questions were derived from an interview-based study and aimed to grasp issues related to human flourishing in addition to more conventional clinical issues related to the transition process. Descriptive statistics were used and ANOVAs to detect differences between the groups when applicable.

RESULTS

86 youths and 94 parents completed the survey. Average scores for TRAQ subscales were high except for "Tracking health issues" and "Appointment keeping". Youths and parents reported being able to give their opinion. Parents were judged to be slightly over-involved. Ongoing involvement of parents in health management was desired. Awareness of differences between pediatric and adult healthcare was high, but a source of notable concern (e.g., accessibility of different medical and professional services). Information on transition was lacking. Installing a pivot-person, visits to the adult hospital, meeting other youths, and accessing transition videos were supported interventions.

CONCLUSION

Transition readiness can be high, but significant challenges can still be present and salient. Youths and adults want to be involved and informed to prepare actively for transition through meetings or adapted materials.

摘要

目的

从儿科医疗向成人医疗的过渡是一个关键时期。相关建议指出,应让青少年及其家庭做好更充分的准备,并加强协调。患者的价值观和偏好等因素若未得到考虑,可能会阻碍临床建议的采纳。这项基于调查的研究旨在更好地了解青少年及其父母在过渡期间面临的挑战、需求以及对干预措施的偏好。

方法

设计了两项在线调查,以探究患有慢性或罕见疾病的青少年及其父母在过渡期间面临的挑战、需求以及对干预措施的偏好。青少年调查问卷包括《过渡准备评估问卷》(TRAQ)的法语翻译版。其他问题源自一项基于访谈的研究,旨在除了了解与过渡过程相关的更传统临床问题外,还能把握与人类幸福相关的问题。使用描述性统计方法,并在适用时采用方差分析来检测组间差异。

结果

86名青少年和94名家长完成了调查。除了“跟踪健康问题”和“遵守预约”外,TRAQ各子量表的平均得分较高。青少年和家长表示能够表达自己的意见。家长被认为参与度略高。希望家长持续参与健康管理。对儿科和成人医疗差异的认识较高,但这也是一个显著的担忧来源(例如,不同医疗和专业服务的可及性)。缺乏关于过渡的信息。设立协调人、前往成人医院就诊、与其他青少年会面以及观看过渡视频等是得到支持的干预措施。

结论

过渡准备程度可能较高,但仍可能存在重大挑战且较为突出。青少年和成年人希望参与其中并了解相关信息,以便通过会议或适用的材料积极为过渡做好准备。

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