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接受家庭肠外营养的慢性肠衰竭青少年和青年的过渡准备情况评估:一项描述性横断面研究。

Transition readiness assessment in adolescents and young adults with chronic intestinal failure on home parenteral nutrition: A descriptive cross-sectional study.

作者信息

Demirok Aysenur, Benninga Marc A, Diamanti Antonella, El Khatib Myriam, Guz-Mark Anat, Hilberath Johannes, Lambe Cécile, Norsa Lorenzo, Sasdelli Anna Simona, Sanchez Alida A, Serlie Mireille, Tabbers Merit M

机构信息

Pediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.

Artificial Nutrition Unit, Bambino Gesù Pediatric Hospital, Rome, Italy.

出版信息

JPEN J Parenter Enteral Nutr. 2025 Jul;49(5):599-608. doi: 10.1002/jpen.2747. Epub 2025 Apr 8.

Abstract

BACKGROUND AND AIMS

Life expectancy for patients with chronic intestinal failure (CIF) recieving home parenteral nutrition (HPN) has improved over the past decades. Consequently, more children on HPN grow into adulthood. Until now, no assessment of transition readiness of these patients exists. Aim is to assess readiness of adolescents recieving HPN.

METHODS

This is an international, prospective, cross-sectional multicenter study in collaboration with members of the Intestinal Failure working group-European Reference Network for Rare Inherited and Congenital (Digestive and Gastrointestinal) Anomalies and the Network of Intestinal Failure and Intestinal Transplant in Europe-European Society for Pediatric Gastroenterology Hepatology and Nutrition conducted between April and November 2023. A validated Transition Readiness Assessment Questionnaire was used to measure patient- and parent-reported transition readiness in adolescents on HPN.

RESULTS

A total of 57 participants aged 16 to 24 years were included across eight countries. Patient-reported outcomes show a lack of readiness for transition among the total cohort with 65% scoring below the threshold. Younger patients (aged 16-18 years), male patients, and those in pediatric settings reported significant lower readiness. Parent-reported scores were higher compared with the patient-reported outcomes, reaching the threshold for transition readiness.

CONCLUSION

The transition readiness of adolescents with CIF receiving HPN presents is proven to be low. This study underscores the necessity for the use of a standardized transition protocol. Emphasizing the importance of successful transition in this vulnerable patient group will enhance the outcomes and independence of adolescents during their transition into the adult healthcare system.

摘要

背景与目的

在过去几十年中,接受家庭肠内营养(HPN)的慢性肠衰竭(CIF)患者的预期寿命有所提高。因此,越来越多接受HPN治疗的儿童成长到成年期。到目前为止,尚未对这些患者的过渡准备情况进行评估。目的是评估接受HPN治疗的青少年的准备情况。

方法

这是一项与肠道衰竭工作组(欧洲罕见遗传和先天性(消化和胃肠道)异常参考网络)以及欧洲肠道衰竭和肠道移植网络(欧洲儿科胃肠病学、肝病学和营养学会)成员合作开展的国际、前瞻性、横断面多中心研究,于2023年4月至11月进行。使用经过验证的过渡准备情况评估问卷来衡量接受HPN治疗的青少年患者及其家长报告的过渡准备情况。

结果

来自八个国家的57名年龄在16至24岁之间的参与者被纳入研究。患者报告的结果显示,整个队列中缺乏过渡准备,65%的患者得分低于阈值。年龄较小的患者(16至18岁)、男性患者以及在儿科环境中的患者报告的准备情况明显较低。与患者报告的结果相比,家长报告的得分更高,达到了过渡准备的阈值。

结论

事实证明,接受HPN治疗的CIF青少年的过渡准备情况较低。这项研究强调了使用标准化过渡方案的必要性。强调在这个脆弱患者群体中成功过渡的重要性将提高青少年向成人医疗系统过渡期间的结果和独立性。

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