P350 为澳大利亚和新西兰的炎症性肠病青少年过渡护理制定共识声明

A. Vernon-Roberts, P. Chan, B. Christensen, R. Havrlant, E. Giles, A. Williams
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摘要

儿科炎症性肠病(IBD)的发病率正在上升,因此,在患有 IBD 的青少年从儿科治疗过渡到成人治疗的过程中,越来越需要为他们提供支持。文献充分支持使用结构化的过渡流程,但在澳大利亚和新西兰,为患有 IBD 的青少年提供的过渡护理服务却存在差异。本研究旨在根据证据和专家意见制定共识声明,以指导 IBD 过渡期护理服务。 共识声明是采用修改后的 UCLA-RAND 方法制定的。首先成立了一个 IBD 专家指导委员会,然后进行了系统的文献综述,对现有证据进行分级,为共识声明的初步制定提供依据。成立了一个由 16 名参与者(临床医生、护士、外科医生、心理学家)组成的多学科小组,对每项共识声明的适当性和必要性进行匿名投票,并为每项共识声明提供一般性反馈意见。评分采用李克特量表[1=最低,9=最高],中位数≥7方可纳入。 指导委员会制定了 14 项共识声明(表 1)。主要建议包括使用结构化过渡计划和过渡协调员。声明建议对心理健康和过渡准备情况进行评估,并概述了应与青少年就生活方式、环境和社会心理因素进行讨论的要点。此外,还强调了专职医疗人员参与的重要性、过渡年龄、临床沟通和交接建议,以及对个别患者的考虑。在多学科小组的第一轮投票中,每项声明的适当性得分中位数≥ 8 分,必要性得分中位数≥ 7 分。两个小组举行了一次在线会议,讨论投票结果并完善声明。表 1.指导大洋洲炎症性肠病患儿转归的最终共识声明。 IBD青少年从儿科到成人的过渡性治疗需要指导。多学科小组在已发表证据的支持下制定了共识声明,以提供指导。计划出版的共识程序和声明将促进澳大拉西亚地区 IBD 过渡期治疗的标准化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
P350 Development of consensus statements for transitional care for adolescents with Inflammatory bowel disease throughout Australia and New Zealand
The incidence of paediatric inflammatory bowel disease (IBD) is rising, and as such there is an increasing need to support adolescents with IBD as they from transition from paediatric to adult care. The use of a structured process for transition is well supported in the literature, however, variation in the delivery of transitional care for adolescents with IBD has been identified across Australis and New Zealand. The aim of this study was to develop consensus statements, based on evidence and expert opinion, to guide transitional care services in IBD. The consensus statements were developed using a modified UCLA-RAND methodology. An IBD expert steering committee was formed, and then a systematic literature review conducted to grade the available evidence and inform initial development of consensus statements. A multi-disciplinary group was formed comprising 16 participants [clinicians, nurses, surgeons, psychologists], that voted anonymously on the level of appropriateness and necessity for each consensus statement, as well as provided general feedback for each. Scoring was facilitated using Likert scales [1=lowest, 9=highest] with a median ≥7 required for inclusion. Fourteen consensus statements were devised by the Steering committee (Table 1). Key recommendations including the use of a structured transition programme and transition coordinator. Statements recommended assessment of mental health and transition readiness, and outlined discussion points regarding lifestyle, environment and psychosocial factors to be held with adolescents. The importance of allied health input, the age for transition, recommendations for clinical communication and handover were highlighted, as well as considerations for individual patients. In the first voting round by the multi-disciplinary group each statement reached a median score of ≥ 8 for appropriateness, and ≥7 for necessity. An online meeting with both groups was held to discuss voting results and refine statements. Table 1. Final consensus statements to guide transition of children with inflammatory bowel disease in Australasia. There is an identified need for guidance in paediatric to adult transitional care for adolescents with IBD. Consensus statements were developed by a multi-disciplinary group, supported by published evidence, to provide this guidance. The planned publication of the consensus process and statements will facilitate standardize delivery of IBD transitional care within Australasia.
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