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Poamaneagra SC, Galos F, Tataranu E, Mihai C, Anton C, Andronic CM, Gilca-Blanariu GE, Balan GG, Timofte O, Anchidin-Norocel L, Rosu OM, Diaconescu S. Transition Readiness in Pediatric Chronic Digestive Diseases: A Regional Perspective from North-Eastern Romania. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:2104. [PMID: 39768983 PMCID: PMC11678283 DOI: 10.3390/medicina60122104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Revised: 12/13/2024] [Accepted: 12/20/2024] [Indexed: 01/11/2025]
Abstract
Background: The transition from the pediatric to the adult healthcare system is a challenging process involving adolescents, parents, and pediatric and adult specialists. For a successful approach for an organized transition program, we must assess the level of training of adolescents facing transition. Methods: We applied a clinic-based questionnaire measuring perceived self-management skills, adherence to health-related tasks, medication knowledge, and social adjustment to pediatric patients with chronic digestive diseases from North-East Romanian medical units, including a tertiary center and private practice offices. Results: There were 124 participants; 73.38% from rural areas, 26.62% from urban areas; 59.67% were females, and 40.33% were males; 91.93% attended school and 73.4% declared wanting to pursue university classes after turning 18. Adolescents from urban areas showed better medication managerial (p < 0.01) and tracking healthcare change skills. Significant correlations were found between medication and appointment making, tracking health dynamics, and communication skills. Other correlations were found between communication skills and medication knowledge, appointments management, and tracking healthcare dynamics. All the investigated domains were positively correlated with the overall scores, highlighting the potential impact of active targeted interventions during transition. Conclusions: We identified significant areas to address and potentially influence during an organized transition program such as communication skills and knowledge regarding the chronic disease and the followed medication.
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Affiliation(s)
- Silvia Cristina Poamaneagra
- Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540139 Targu Mures, Romania; (S.C.P.); (O.M.R.)
| | - Felicia Galos
- Marie Curie Emergency Childrens Hospital, 077120 Bucharest, Romania
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Elena Tataranu
- Clinical Department of Pediatrics, Sf. Ioan cel Nou, Emergency Hospital, 720224 Suceava, Romania
| | - Catalina Mihai
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.M.); (C.A.); (C.-M.A.); (G.-E.G.-B.); (G.G.B.); (O.T.)
- Department of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Carmen Anton
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.M.); (C.A.); (C.-M.A.); (G.-E.G.-B.); (G.G.B.); (O.T.)
- Department of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Cristiana-Mihaela Andronic
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.M.); (C.A.); (C.-M.A.); (G.-E.G.-B.); (G.G.B.); (O.T.)
- Department of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Georgiana-Emmanuela Gilca-Blanariu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.M.); (C.A.); (C.-M.A.); (G.-E.G.-B.); (G.G.B.); (O.T.)
- Department of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Gheorghe G. Balan
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.M.); (C.A.); (C.-M.A.); (G.-E.G.-B.); (G.G.B.); (O.T.)
- Department of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Oana Timofte
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.M.); (C.A.); (C.-M.A.); (G.-E.G.-B.); (G.G.B.); (O.T.)
- Department of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Liliana Anchidin-Norocel
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania;
| | - Oana Maria Rosu
- Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540139 Targu Mures, Romania; (S.C.P.); (O.M.R.)
| | - Smaranda Diaconescu
- Faculty of Medicine, “Titu Maiorescu” University of Medicine, 050474 Bucharest, Romania;
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Borgia RE, De Cunto CL, Terreri MT, Guerini LL, Espada G. Transition From Pediatric to Adult Rheumatology Care: An Exploratory Study From Latin America. J Clin Rheumatol 2024:00124743-990000000-00184. [PMID: 38206911 DOI: 10.1097/rhu.0000000000002055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND/PURPOSE Adequate transition from pediatric to adult care is associated with better adherence to treatment and better outcomes in pediatric patients with chronic diseases. There are little data on transition programs, outcomes, use of transition guidelines, and available tools in pediatric rheumatology centers from Latin America (LATAM). In this study, we described the characteristics of transition programs from 3 pediatric rheumatology centers. We also introduced results of the first survey examining the transition experience in countries from LATAM. METHODS The experience and implementation process of transition programs from 3 pediatric rheumatology centers were described. A survey based on a questionnaire created by Chira et al (J Rheumatol. 2014;41:768-779) from the Childhood Arthritis and Rheumatology Research Alliance was also administrated to pediatric rheumatology centers from LATAM. RESULTS A total of 49 (68%) pediatric rheumatologists answered the survey. Most centers do not have an official and written transition program and reported a need for more tools and resources in their services to facilitate the transition experience. CONCLUSIONS Transition guidelines culturally tailored to developing countries are needed in LATAM.
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Affiliation(s)
- R Ezequiel Borgia
- From the Division of Pediatric Allergy, Immunology, and Rheumatology, University Hospitals Rainbow Babies and Children's Hospital, Cleveland, OH
| | - Carmen L De Cunto
- Pediatric Rheumatology Section, Department of Pediatrics, Hospital Italiano, Buenos Aires, Argentina
| | - Maria Teresa Terreri
- Pediatric Rheumatology Section, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - L Lorena Guerini
- Rheumatology Section, Hospital de Niños Dr Ricardo Gutierrez, Buenos Aires, Argentina
| | - Graciela Espada
- Rheumatology Section, Hospital de Niños Dr Ricardo Gutierrez, Buenos Aires, Argentina
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Zhou M, Xu Y, Zhou Y. Factors influencing the healthcare transition in Chinese adolescents with inflammatory bowel disease: a multi-perspective qualitative study. BMC Gastroenterol 2023; 23:445. [PMID: 38110881 PMCID: PMC10729466 DOI: 10.1186/s12876-023-03080-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/08/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The development and implementation of the transition from pediatric to adult healthcare systems for adolescents with inflammatory bowel disease (IBD) should consider stakeholders' perceptions. This study aimed to explore the factors influencing the transition of Chinese adolescents with IBD from the perspectives of patients, parents, and healthcare providers. METHODS A descriptive qualitative research was conducted. Purposive sampling was used to recruit 36 participants, including 13 patients, 13 parents, and 10 providers, from a tertiary pediatric IBD center, a tertiary adult IBD center, and the China Crohn's & Colitis Foundation in Zhejiang Province, China. Individual semi-structured interviews were used to collect data on facilitators and barriers to the transition process. Conventional content analysis was used to analyze the interview transcripts. RESULTS Nine primary themes were identified. Patients with young age, prolonged disease duration, severe disease, academic pressures such as the Gaokao, low level of disease acceptance, limited transition consciousness, low self-efficacy, poor transition communication, and inadequate medical transition system serve as barriers. While patients with the mentality of guilt towards their parents; parents with low education levels and intensive work schedules, high levels of disease acceptance, and situations of parent-child separation; stakeholders with high transition consciousness, high transition self-efficacy, and effective transition communication act as facilitators. Furthermore, community support and hospital guide services were also contributing factors during the transition. CONCLUSIONS This study offers comprehensive insights into the factors affecting the transition of Chinese adolescent IBD patients. The process is continuously influenced by stakeholders, community, and healthcare environments and policies. Identifying these factors provides healthcare providers with a reference for developing and implementing targeted transition interventions.
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Affiliation(s)
- Mi Zhou
- School of Nursing, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang, 310053, China
| | - Youjun Xu
- School of Nursing, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang, 310053, China
| | - Yunxian Zhou
- School of Nursing, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang, 310053, China.
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