Comfort of general internists and general pediatricians in providing care for young adults with chronic illnesses of childhood
Comfort of general internists and general pediatricians in providing care for young adults with chronic illnesses of childhood
复制标题
DOI：
10.1007/s11606-008-0716-8
复制
发表时间：
2008-10-01
影响因子：
5.7
通讯作者：
Kerr, Eve A.
中科院分区：
文献类型：
--
作者：
Okumura, Megumi J.;Heisler, Michele;Kerr, Eve A.
背景技术背景：随着越来越多的儿童慢性病患者活到成年，专家建议年轻的慢性病患者从以儿童为中心的初级保健转移到以成人为中心的初级保健。然而，很少有人知道如何舒适的医生照顾这个population.Objective：为了评估舒适的普通内科医生和普通儿科医生在治疗年轻的成人慢性疾病起源于儿童以及与舒适的相关因素。在一项随机抽样中，2434名合格的美国普通内科医生和儿科医生中有1288人完成了一项邮寄调查方法：我们测量了受访者在为镰状细胞病（SCD）或囊性纤维化（CF）患者提供初级护理时的舒适度。我们还测量了疾病的熟悉程度，培训和亚专业的支持，以及个别医生的characteristics.RESULTS：15%的普通内科医生报告舒适的初级保健提供者为成人CF和32%的报告舒适的初级保健为成人SCD，相比之下，38%的儿科医生CF（p 0.05）。不到一半的普通内科医生认为，他们的专业应该采取初级保健责任的成人患者CF和SCD。结论：大多数普通内科医生和儿科医生不舒服提供初级保健的年轻人与慢性疾病的儿童起源，如CF和SCD。努力提高提供者的治疗舒适度可能有助于向以成人为中心的护理过渡，以适应越来越多的患有复杂慢性病的年轻人。
BACKGROUND: As an increasing number of patients with chronic conditions of childhood survive to adulthood, experts recommend that young adults with chronic conditions transfer from child-focused to adult-focused primary care. Little, however, is known about how comfortable physicians are caring for this population.OBJECTIVE: To assess the comfort of general internists and general pediatricians in treating young adult patients with chronic illnesses originating in childhood as well as the factors associated with comfort.PARTICIPANTS: In a random sample, 1288 of 2434 eligible US general internists and pediatricians completed a mailed survey (response rate = 53%).METHODS: We measured respondents' comfort level in providing primary care for a patient with sickle cell disease (SCD) or cystic fibrosis (CF). We also measured levels of disease familiarity, training and subspecialty support, as well as individual physician characteristics.RESULTS: Fifteen percent of general internists reported being comfortable as the primary care provider for adults with CF and 32% reported being comfortable providing primary care for adults with SCD, compared with 38% of pediatricians for CF (p 0.05). Less than half of general internists felt that their specialty should take primary care responsibility for adult patients with CF and SCD.CONCLUSIONS: A majority of general internists and pediatricians are not comfortable providing primary care for young adults with chronic illnesses of childhood origin, such as CF and SCD. Efforts to increase treatment comfort among providers may help with the transition to adult-focused care for the growing numbers of young adults with complex chronic conditions.