Exploring Adult Care Experiences and Barriers to Transition in Adult Patients with Sickle Cell Disease.
Exploring Adult Care Experiences and Barriers to Transition in Adult Patients with Sickle Cell Disease.
复制标题
DOI：
10.15436/2381-1404.15.003
复制
发表时间：
2015-01-01
期刊：
影响因子：
--
通讯作者：
Lebensburger, J D
中科院分区：
文献类型：
--
作者：
Bemrich-Stolz, C J;Halanych, J H;Lebensburger, J D
背景：患有镰状细胞性贫血的年轻人在过渡到成人护理时住院和死亡的风险很高。这可能与过渡系统未能为年轻人做好进入成人医疗保健系统的准备有关。这项定性研究旨在确定可能影响成人镰状细胞性贫血患者健康的过渡相关因素。 程序：目前在成人血液学诊所接受治疗的 10 名患者参加了半结构化定性访谈，以描述他们从儿科护理过渡到成人护理的经历以及成人和儿科医疗保健系统的差异。 结果：参与者普遍对成人医疗保健系统没有做好准备。参与者经历的负面问题包括医生不信任、与雇主的困难、保留保险以及人际关系压力。参与者经历的积极问题包括通过改善自我护理和自主性来提高自我效能。结论：在缺乏正式的过渡计划的情况下，患有镰状细胞性贫血的成年人在成人护理方面遇到了重大障碍。除了病史审查和成人医疗服务提供者的识别之外，过渡计划还应纳入成人医疗系统、保险和人际关系以及鼓励自我效能的策略。
BACKGROUND: Young adults with sickle cell anemia are at high risk for increased hospitalization and death at the time of transition to adult care. This may be related to failure of the transition system to prepare young adults for the adult healthcare system. This qualitative study was designed to identify factors related to transition that may affect the health of adults with sickle cell anemia.PROCEDURE: Ten patients currently treated in an adult hematology clinic participated in semi-structured qualitative interviews to describe their experience transitioning from pediatric to adult care and differences in adult and pediatric healthcare systems.RESULTS: Participants were generally unprepared for the adult healthcare system. Negative issues experienced by participants included physician mistrust, difficulty with employers, keeping insurance, and stress in personal relationships. Positive issues experienced by participants included improved self efficacy with improved self care and autonomy.CONCLUSIONS: In the absence of a formalized transition program, adults with sickle cell anemia experience significant barriers to adult care. In addition to medical history review and identification of an adult provider, transition programs should incorporate strategies to navigate the adult medical system, insurance and relationships as well as encouraging self efficacy.