Perspectives From Before and After the Pediatric to Adult Care Transition: A Mixed-Methods Study in Type 1 Diabetes

被引:97
作者
Hilliard, Marisa E. [1 ]
Perlus, Jessamyn G. [2 ]
Clark, Loretta M. [3 ]
Haynie, Denise L. [2 ]
Plotnick, Leslie P. [1 ]
Guttmann-Bauman, Ines [3 ]
Iannotti, Ronald J. [2 ]
机构
[1] Johns Hopkins Univ, Sch Med, Baltimore, MD USA
[2] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Bethesda, MD 20892 USA
[3] Johns Hopkins Univ Hosp, Baltimore, MD 21287 USA
关键词
YOUNG-ADULTS; HEALTH-CARE; SELF-MANAGEMENT; EMERGING ADULTS; GLYCEMIC CONTROL; ADOLESCENTS; SERVICES; PROGRAM;
D O I
10.2337/dc13-1346
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVEAmong the many milestones of adolescence and young adulthood, transferring from pediatric to adult care is a significant transition for those with type 1 diabetes. The aim of this study was to understand the concerns, expectations, preferences, and experiences of pretransition adolescents and parents and posttransition young adults.RESEARCH DESIGN AND METHODSParticipants completed questionnaires and responded to open-ended qualitative questions regarding self-management, self-efficacy, and their expectations and experiences with pediatric and adult care providers across the transition process.RESULTSAt a mean age of 16.1 years, most pretransition adolescents had not yet discussed transferring care with their parents or doctors. Although many posttransition young adults reported positive, supportive interactions, several described challenges locating or establishing a relationship with an adult diabetes care provider. Qualitative themes emerged related to the anticipated timing of transfer, early preparation for transition, the desire for developmentally appropriate interactions with providers, the maintenance of family and social support, and strategies for coordinating care between pediatric and adult care providers.CONCLUSIONSStandardizing transition preparation programs in pediatric care and introducing transition-oriented clinics for late adolescents and young adults prior to adult care may help address patients' preferences and common transfer-related challenges.
引用
收藏
页码:346 / 354
页数:9
相关论文
共 36 条
[1]   The transition from children's to adult diabetes services: understanding the 'problem' [J].
Allen, D. ;
Gregory, J. .
DIABETIC MEDICINE, 2009, 26 (02) :162-166
[2]  
Anderson B.J., 2010, DIABETES SPECTRUM, V23, P32, DOI DOI 10.2337/DIASPECT.23.1.32
[3]  
Arnett JJ, 2000, AM PSYCHOL, V55, P469
[4]   Poor prognosis of young adults with type 1 diabetes - A longitudinal study [J].
Bryden, KS ;
Dunger, DB ;
Mayou, RA ;
Peveler, RC ;
Neil, HAW .
DIABETES CARE, 2003, 26 (04) :1052-1057
[5]   Clinical and psychological course of diabetes from adolescence to young adulthood - A longitudinal cohort study [J].
Bryden, KS ;
Peveler, RC ;
Stein, A ;
Neil, A ;
Mayou, RA ;
Dunger, DB .
DIABETES CARE, 2001, 24 (09) :1536-1540
[6]   Evaluation of patients' opinion and metabolic control after transfer of young adults with type 1 diabetes from a pediatric diabetes clinic adult care [J].
Busse, F. P. ;
Hiermann, P. ;
Galler, A. ;
Stumvoll, M. ;
Wiessner, T. ;
Kiess, W. ;
Kapellen, T. M. .
HORMONE RESEARCH, 2007, 67 (03) :132-138
[7]   Transition process of patients with type 1 diabetes (T1DM) from paediatric to the adult health care service: a hospital-based approach [J].
Cadario, F. ;
Prodam, F. ;
Bellone, S. ;
Trada, M. ;
Binotti, M. ;
Trada, M. ;
Allochis, G. ;
Baldelli, R. ;
Esposito, S. ;
Bona, G. ;
Aimaretti, G. .
CLINICAL ENDOCRINOLOGY, 2009, 71 (03) :346-350
[8]   Focus on Preventive Health Care for Young Adults [J].
Callahan, S. Todd .
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 2012, 166 (03) :289-290
[9]   Transition from pediatric to adult-oriented health care: a challenge for patients with chronic disease [J].
Callahan, ST ;
Feinstein, R ;
Keenan, P .
CURRENT OPINION IN PEDIATRICS, 2001, 13 (04) :310-316
[10]  
Doherty Y., 2005, PRACTICAL DIABETES I, V22, P59, DOI DOI 10.1002/PDI.751