Enabling successful transition-Evaluation of a transition to adult care program for pediatric liver transplant recipients

被引:3
|
作者
Culnane, Evelyn [1 ]
Loftus, Hayley [1 ,2 ]
Peters, Rebecca [1 ]
Haydar, Madeleine [1 ]
Hodgson, Alexandra
Herd, Lauren [3 ]
Hardikar, Winita [3 ,4 ,5 ]
机构
[1] Royal Childrens Hosp RCH Melbourne, Dept Adolescent Med, Transit Support Serv, Parkville, Vic, Australia
[2] Murdoch Childrens Res Inst, Hlth Serv, Melbourne, Vic, Australia
[3] Royal Childrens Hosp RCH Melbourne, Dept Gastroenterol & Hepatol, Parkville, Vic, Australia
[4] Univ Melbourne, Dept Pediat, Parkville, Vic, Australia
[5] Murdoch Childrens Res Inst, Populat Allergy, Melbourne, Vic, Australia
关键词
adolescent and young adult; liver transplant recipients; liver transplantation; transition to adult care; HEALTH-CARE; ADOLESCENTS; READINESS; ADHERENCE; OUTCOMES; MANAGEMENT; SERVICES; PATIENT;
D O I
10.1111/petr.14213
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background This study aimed to evaluate the transition to adult care program instituted for liver transplant recipients (LTRs) at a large tertiary pediatric hospital in Melbourne, Australia. Evaluation included the change in a Global Assessment Measure (GAM) before and after the transition program, satisfaction with the program, and measures of transition success including rejection rates and attendance at appointments post-transfer. We hypothesized that the introduction of our structured transition program would improve disease understanding, health system understanding, and self-care. We also hypothesized that those who had undergone the transition program would have lower failure to attend rates and lower rates of rejection than historical controls. Methods A LTR transition program was instituted at our service from 2013 to 2015. The program involved initial assessment of competencies with a Global Assessment Measure (GAM), followed by the introduction of a personalized goal setting program addressing issues identified in dedicated transition clinics. Assessment of competencies was compared between the commencement of the program and immediately prior to transfer. Patient satisfaction with the transition process was assessed at an interview 6-12 months after transfer to the adult service. Rejection rates and failure to attend rates were compared between the intervention group and a group of LTRs who did not receive the intervention. Results Twenty-eight LTRs participated in the study; 20 received the transition intervention and 8 served as controls. Within the intervention group, all domains of transition competency and reported anxiety regarding transferring had significantly improved at the conclusion of the intervention and all reported satisfaction with the transition program with most (81%) reporting readiness to transfer. There were no significant differences in rejection rates or failure to attend rates between those who did and did not receive the transition intervention. Conclusion A longitudinal holistic transition program has the potential to positively impact the competencies and readiness of LTRs to successful transition and transfer to adult care.
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页数:11
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