Vallmark Mikaela, Brorsson Anna Lena, Acuña Mora Mariela, Bratt Ewa-Lena, Moons Philip, Saarijärvi Markus, Chisalita Simona, Sparud-Lundin Carina
University of Gothenburg Institute of Health and Care Sciences, Gothenburg, Västra Götaland County, Sweden
University of Gothenburg Centre for Person-Centred Care, Gothenburg, Västra Götaland County, Sweden.
BMJ Open Diabetes Res Care. 2025 Jul 27;13(4):e004921. doi: 10.1136/bmjdrc-2025-004921.
Emerging adults with chronic conditions, such as type 1 diabetes (T1D), face vulnerability during transition to adulthood and transfer to adult care. Facilitating transition preparation, disease-related knowledge acquisition, self-management, and follow-up has proved to improve transition readiness and experiences. Few studies exist on conditions related to emerging adults' transition and transfer, and how these associate with other relevant variables. The purpose of this study was to describe experiences of emerging adults with T1D regarding transitional care before transfer, and to explore potential correlates of these experiences.
A cross-sectional study including 162 emerging adults with T1D was performed at eight Swedish adult diabetes clinics. The primary outcome was transition and transfer experiences measured by TEXP-Q (Transitional care EXPeriences Questionnaire)-a novel PREM (patient-reported experience measure). Correlations between TEXP-Q and sex, glycated hemoglobin, time to follow-up, empowerment, the healthcare climate in adult care, and diabetes self-efficacy were investigated.
The mean average score of TEXP-Q (range 1-5) was 3.6±0.7 for the total scale, and for subscales: Healthcare-provider communication 4.5±0.7, autonomy and participation 3.5±0.9, and transition and transfer preparation 3.0±1.1. Sex proved to be significant only for transition and transfer preparation (p=0.004), demonstrating better perceived preparation among men compared with women. Positive experiences from transition and transfer were associated with higher level of empowerment (rho 0.34, p<0.001), diabetes self-efficacy (rho 0.32, p<0.001) and satisfaction with the healthcare climate in adult care (rho 0.36, p<0.001).
In this study we used a novel measure, TEXP-Q, to explore experiences of transitional care preparation among emerging adults with T1D. While most participants reported high satisfaction with the healthcare-provider communication, fewer reported feeling sufficiently prepared for the transition and transfer processes. The potential correlates investigated could not with conviction be regarded as important for the transition and transfer experiences. Using TEXP-Q in clinical practice may provide vital information when evaluating existing healthcare practices for emerging adults with T1D, and when planning for improvement of care offered to emerging adults in preparation for transition and transfer.
患有慢性疾病（如1型糖尿病，T1D）的青年在向成年期过渡并转至成人护理时面临着诸多挑战。事实证明，促进过渡准备、疾病相关知识获取、自我管理以及后续跟进能够提高过渡准备程度和体验。关于青年过渡与转至成人护理相关情况以及这些情况如何与其他相关变量相关联的研究较少。本研究的目的是描述患有T1D的青年在转至成人护理之前的过渡护理经历，并探索这些经历的潜在相关因素。
在瑞典的8家成人糖尿病诊所开展了一项横断面研究，纳入了162名患有T1D的青年。主要结局是通过TEXP-Q（过渡护理体验问卷）——一种新的患者报告体验测量工具来衡量的过渡与转至成人护理的经历。研究了TEXP-Q与性别、糖化血红蛋白、随访时间、赋权、成人护理中的医疗氛围以及糖尿病自我效能之间的相关性。
TEXP-Q（范围为1-5）的总分平均得分为3.6±0.7，各子量表得分如下：医护人员沟通为4.5±0.7，自主性与参与度为3.5±0.9，过渡与转至成人护理准备为3.0±1.1。结果表明，性别仅在过渡与转至成人护理准备方面具有显著差异（p=0.004），男性比女性感觉准备得更好。过渡与转至成人护理的积极经历与更高水平的赋权（相关系数0.34，p<0.001）、糖尿病自我效能（相关系数0.32，p<0.001）以及对成人护理中医疗氛围的满意度（相关系数0.36，p<0.001）相关。
在本研究中，我们使用了一种新的测量工具TEXP-Q来探索患有T1D的青年的过渡护理准备经历。虽然大多数参与者对医护人员沟通表示高度满意，但较少有人表示对过渡和转至成人护理过程有充分准备。所研究的潜在相关因素不能确凿地被视为对过渡与转至成人护理经历很重要。在临床实践中使用TEXP-Q，在评估针对患有T1D的青年的现有医疗实践以及规划改善为青年提供的护理以帮助其为过渡和转至成人护理做准备时，可能会提供重要信息。
