Gaps in transition readiness measurement: a comparison of instruments to a conceptual model.
Gaps in transition readiness measurement: a comparison of instruments to a conceptual model.
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过渡准备度测量的差距：将仪器与概念模型进行比较。
DOI：
10.1515/jtm-2022-0002
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发表时间：
2022-01-01
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在让患有慢性病的年轻人成功过渡到成人护理方面做好准备时，衡量过渡准备情况非常重要。青少年和年轻人过渡准备的扩展社会生态模型（扩展 SMART）提供了影响过渡准备和结果的因素的整体观点。本研究的目的是检查过渡准备工具与扩展 SMART 的概念一致性，以确定测量结构的广度和频率。对 PubMed 进行搜索，以确定衡量慢性病过渡准备情况的观察性和实验性研究。首先评估所选仪器的发展和心理测量特性。接下来，评审者独立地将每个工具项目映射到扩展的 SMART 结构：知识、技能/自我效能、关系/沟通、社会心理/情感、发展成熟度、信念/期望、目标/动机。如果项目没有映射到构造，则通过小组讨论归纳命名新的构造。确定了 74 项研究中报告的三种工具（TRAQ [20 项]、STARx [18 项] 和 TRxANSITION Index [32 项]）。在各种工具中，大多数项目映射到三个结构：技能/自我效能、发展成熟度和知识。目标/动机和心理社会/情感的心理社会结构在这些工具中没有得到充分体现。没有仪器映射到每个模型构造。确定了两个新的结构：独立生活和组织。三种常用的转型准备工具中代表转型准备的结构与扩展 SMART（转型准备的整体概念模型）有很大不同，这表明转型准备的概念化和操作化并不标准化。没有任何工具能够反映转型准备情况的所有概念结构，而心理社会结构的代表性不足，这表明当前的工具可能无法完整地衡量转型准备情况。
Measuring transition readiness is important when preparing young people with chronic illness for successful transition to adult care. The Expanded Socioecological Model of Adolescent and Young Adult Readiness to Transition (Expanded SMART) offers a holistic view of factors that influence transition readiness and outcomes. The aim of this study was to examine conceptual congruency of transition readiness instruments with the Expanded SMART to determine the breadth and frequency of constructs measured. PubMed was searched to identify observational and experimental studies that measured transition readiness across chronic illnesses. Selected instruments were first evaluated on their development and psychometric properties. Next, reviewers independently mapped each instrument item to Expanded SMART constructs: knowledge, skills/self-efficacy, relationships/communication, psychosocial/emotions, developmental maturity, beliefs/expectations, goals/motivation. If items did not map to a construct, a new construct was named inductively through group discussion. Three instruments (TRAQ [20 items], STARx [18 items] and TRxANSITION Index [32 items]), reported in 74 studies, were identified. Across instruments, most items mapped to three constructs: skills/self-efficacy, developmental maturity, and knowledge. The psychosocial constructs of goals/motivation and psychosocial/emotions were underrepresented in the instruments. No instrument mapped to every model construct. Two new constructs: independent living and organization were identified. Constructs representing transition readiness in three frequently used transition readiness instruments vary considerably from Expanded SMART, a holistic conceptual model of transition readiness, suggesting that conceptualization and operationalization of transition readiness is not standardized. No instrument reflected all conceptual constructs of transition readiness and psychosocial constructs were underrepresented, suggesting that current instruments may provide an incomplete measurement of transition readiness.