爱尔兰脑瘫青少年从儿童保健服务向成人保健服务的过渡;一项混合方法研究的启示

Jennifer M. Ryan, M. Norris, Aisling Walsh, Amanda Breen, O. Hensey, Claire Kerr, Sebastian Koppe, G. Lavelle, M. Owens, M. Walsh, Thilo Kroll, Jennifer Fortune
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摘要

背景 从以儿童为导向的医疗保健向以成人为导向的医疗保健过渡不顺畅,可能会导致负面结果以及成年后对服务的不满。本研究的目的是探讨如何为爱尔兰患有慢性阻塞性肺病的青少年提供过渡服务,以及他们在过渡过程中的感受。本报告综合了定量和定性研究结果,并根据所获得的全部知识提供了相关启示。研究方法 开展了一项趋同平行混合方法研究。通过问卷调查和半结构式访谈,从 16-22 岁的脊髓灰质炎患者、家长和医疗专业人员处收集数据,并以九个关键过渡实践框架为依据。在研究的解释阶段,通过联合展示整合了定量和定性研究结果。通过与医疗专业人员、青少年和家长的讨论,得出了研究的意义。结果 75 名青少年/家长和 108 名医疗专业人员完成了调查问卷。对 13 名青少年、14 名家长和 27 名医疗专业人员进行了访谈。定量和定性调查结果之间存在互补性,表明缺乏指定的工作人员、提供的信息有限、自我管理支持不足、没有机会与成人团队会面、与全科医生的接触有限以及没有机会参加正规的生活技能培训。关于家长参与的适当程度,定量研究结果与定性研究结果不一致。在促进健康自我效能感和负责过渡的高级管理人员方面,定量研究结果与定性研究结果不一致,定量研究结果表明大多数年轻人都不具备这些能力,但定性研究结果却没有描述这些做法。 结论 综合研究结果的影响包括:需要标准化的过渡途径,采取有意识的行动使家长和年轻人能够适应角色的转变,以合作和分阶段的方式提供信息,年轻人、家长和医疗专业人员对自我管理有共同的理解,以及需要成人服务和全科医生参与过渡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transition from child to adult health services for young people with cerebral palsy in Ireland; implications from a mixed-methods study
Background Poor transition from child- to adult-oriented healthcare may lead to negative outcomes and dissatisfaction with services in adulthood. The aim of the study was to examine how transition is provided to and experienced by young people with CP in Ireland. This report provides integrated quantitative and qualitative findings and implications based on the totality of knowledge generated. Methods A convergent parallel mixed-methods study was conducted. Data were collected from people with CP aged 16-22 years, parents, and health professionals using surveys and semi-structured interviews, informed by a framework of nine key transition practices. Quantitative and qualitative findings were integrated at the interpretation stage of the research using integration through joint displays. Implications were developed through discussions with health professionals, young people, and parents. Results Surveys were completed by 75 young people/parents and 108 health professionals. Interviews were conducted with 13 young people, 14 parents, and 27 health professionals. There was complementarity between quantitative and qualitative findings indicating lack of a named worker, limited information provision, insufficient self-management support, no opportunity to meet the adult team, limited contact with the GP, and no opportunity for attending formal life skills training. There was dissonance between quantitative and qualitative findings regarding appropriate level of parental involvement. There was silence between quantitative and qualitative findings for promotion of health self-efficacy and senior manager responsible for transition, with quantitative findings indicating these were not present for most young people, but qualitative findings not describing these practices Conclusion Implications of integrated findings include the need for a standardised transition pathway, intentional actions to enable parents and young people to adapt to changing roles, provision of information in a collaborative and phased approach, a common understanding of self-management between young people, parents and health professionals, and the need to involve adults’ services and GPs in transition.
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