Transition of care readiness among adolescents with chronic pain between 2021-2022 in a Nationally representative sample

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain Pub Date : 2025-02-08 DOI:10.1016/j.jpain.2025.105333

Daron M. Vandeleur MD , Tonya M. Palermo PhD

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引用次数: 0

Abstract

Chronic pain impacts 11–33% of children and will continue into adulthood for over half of them. Transition of pain management to adult care is crucial given high risk of interruption of care which is associated with subsequent poor medical, social, and vocational outcomes. Yet the transition experience for these youth is poorly characterized. Using a sample from the 2021 and 2022 National Survey of Children’s Health (conducted by parent report), we aimed to determine the prevalence of transition readiness among adolescents with chronic pain in the U.S. and estimate the association of readiness with biopsychosocial-cultural and health system characteristics. Of the 2584 adolescents aged 14–17 with chronic pain, 23.9% of adolescents met criteria for transition readiness. Using Poisson regression, we determined those more likely to meet criteria were older (PR 1.8 95%CI: 1.3, 2.6), female (PR 1.6 95% CI: 1.2, 2.2), White (Asian PR 0.4, 95% CI: 0.2, 0.9, Multi-racial PR 0.6 95% CI: 0.4, 0.9), and experienced shared decision making (aPR 1.7 95% CI: 1.1, 2.8). Fewer than half met criteria for medical home, effective care coordination, and adequate insurance. Poor mental health emerged as a concern with high levels of anxiety and/or depression (48%) and low levels of flourishing (42%). This is an important first step in demonstrating low transition readiness among adolescents with chronic pain and identifying mental health and healthcare continuity concerns. Future research should incorporate stakeholder perspectives and investigate pain specific factors relevant to transition readiness and investigate how readiness relates to transition outcomes.

Perspective

This article establishes low readiness to transition from pediatric to adult healthcare among adolescents with chronic pain and identifies disparities in readiness. Poor mental health and inadequate healthcare access were identified as factors which may impact transition intervention delivery. These findings can guide development and implementation of a transition intervention.

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在全国代表性样本中，2021-2022年慢性疼痛青少年的护理准备转变

慢性疼痛影响了11-33%的儿童，其中一半以上的儿童会持续到成年。将疼痛管理过渡到成人护理是至关重要的，因为护理中断的风险很高，这与随后不良的医疗、社会和职业结果有关。然而，这些年轻人的过渡经历却没有得到很好的描述。使用2021年和2022年全国儿童健康调查（由家长报告进行）的样本，我们旨在确定美国慢性疼痛青少年中过渡准备的患病率，并估计准备与生物心理社会文化和卫生系统特征的关联。在2,584名14-17岁患有慢性疼痛的青少年中，23.9%的青少年符合过渡准备标准。使用泊松回归，我们确定了更可能符合标准的人是老年人（PR为1.8 95%CI: 1.3, 2.6），女性（PR为1.6 95%CI: 1.2, 2.2），白人（亚洲PR为0.4,95%CI: 0.2, 0.9，多种族PR为0.6 95%CI: 0.4, 0.9），以及有共同决策经验的人（aPR为1.7 95%CI: 1.1, 2.8）。不到一半的人符合医疗之家、有效护理协调和充分保险的标准。心理健康状况不佳成为高度焦虑和/或抑郁（48%）和低水平繁荣（42%）的一个问题。这是证明慢性疼痛青少年过渡准备程度低和确定心理健康和保健连续性问题的重要的第一步。未来的研究应纳入利益相关者的观点，调查与过渡准备相关的疼痛特定因素，并调查准备与过渡结果的关系。观点：这篇文章建立了低准备从儿科过渡到成人医疗保健青少年慢性疼痛和确定准备的差异。心理健康状况不佳和保健机会不足被确定为可能影响过渡干预措施实施的因素。这些发现可以指导过渡干预措施的制定和实施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pain 医学-临床神经学

CiteScore

6.30

自引率

7.50%

发文量

441

审稿时长

42 days

期刊介绍： The Journal of Pain publishes original articles related to all aspects of pain, including clinical and basic research, patient care, education, and health policy. Articles selected for publication in the Journal are most commonly reports of original clinical research or reports of original basic research. In addition, invited critical reviews, including meta analyses of drugs for pain management, invited commentaries on reviews, and exceptional case studies are published in the Journal. The mission of the Journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals to publish original research.