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Hong HS, Im Y. Factors associated with healthcare transition readiness for adolescents with chronic conditions: A cross-sectional study. J Child Health Care 2024:13674935241248859. [PMID: 38669312 DOI: 10.1177/13674935241248859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Healthcare transition readiness (HCTR) plays a vital role by fostering autonomy, self-management skills, and active involvement in healthcare, leading to positive health outcomes. This study aimed to examine the factors associated with HCTR in adolescents with chronic conditions (ACCs) including adolescents' autonomy, parental overprotection, and autonomy support from healthcare providers (HCPs). This descriptive study included 107 adolescents aged 14-19 years (median age: 17 years, IQR = 1), recruited from online communities and support groups in South Korea. Data were analyzed using hierarchical linear regression. Our research has shown that HCTR is linked to a lower level of parental overprotection (β = -0.46, 95% CI [-0.59, -0.33]) and higher levels of autonomy support from HCPs (β = 0.46, 95% CI [0.36, 0.56]). Among general characteristics, we also found that having a transfer plan to adult care (β = 0.24, 95% CI [0.04, 0.44]) is significantly associated with HCTR. This study contributes to a broader understanding of HCTR by examining its associated factors in ACC. The results emphasize the pivotal roles of parental involvement, healthcare provider support, and structured transition to adult care in enhancing HCTR. These findings underscore the need for comprehensive assistance to ensure successful healthcare transitions.
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Affiliation(s)
- Hye Seung Hong
- Department of Delivery Room, Chung-Ang University Gwang Myeong Hospital, Gwangmyeong-si, Republic of Korea
- Department of Nursing, Graduate School, Kyung Hee University, Republic of Korea
| | - YeoJin Im
- College of Nursing Science, East-West Nursing Research Institute, Kyung Hee University, Seoul, Republic of Korea
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Al Ksir K, Wood DL, Hasni Y, Sahli J, Quinn M, Ghardallou M. Motivational interviewing to improve self-management in youth with type 1 diabetes: A randomized clinical trial. J Pediatr Nurs 2022; 66:e116-e121. [PMID: 35568602 DOI: 10.1016/j.pedn.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 04/23/2022] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Effective interventions are needed to help adolescents with T1D develop independent self-management skills to prevent commonly observed deterioration of disease self-management resulting in poor health outcomes. Using a prospective RCT design, we assessed the impact of a nurse-led education program based on motivational interviewing (MI) in youth with Type 1 diabetes (T1D). DESIGN AND METHODS After parental consent and youth assent, we prospectively randomized 66 adolescents 13-18 years old with T1D to either usual care (every 3 months visit with pediatric endocrinologist) or usual care supplemented by 2 in-person and 4 follow-up phone calls with a nurse educator in a pediatric endocrinology clinic of the University Hospital Farhat Hached, Sousse, Tunisia. We used MI sessions to support youth general and disease specific self-management skills. Outcomes were change, between baseline and 6 months, in TRAQ (a validated measure of youth self-management) scores and HbA1c values. RESULTS Mean TRAQ scores (based on a 5-point Likert scale) increased by 1.44 points (s.d. = 0.56) in the Intervention Group versus 0.26 points (s.d. = 0.34) in the control group (p < 0.001). The mean HbA1C value decreased in the intervention group by 0.95 units versus a decrease of 0.12 units in the control group (p = 0.047). CONCLUSION We found that a brief, nurse-led MI-based educational intervention, integrated into specialty pediatric care, resulted in a significant improvement in both self-reported self-management skills and in HbA1c values. TRIAL REGISTRATION Registered in ClinicalTrials.gov Identifier: NCT04798937.
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Affiliation(s)
- Kawther Al Ksir
- College of Public Health, East Tennessee State University, Johnson City, TN, United States of America.
| | - David L Wood
- College of Public Health, East Tennessee State University, Johnson City, TN, United States of America; Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States of America
| | - Yosra Hasni
- Farhat Hached University Hospital Center, Endocrinology Department, Sousse, Tunisia
| | - Jihene Sahli
- Department of Family and Community Medicine, University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Megan Quinn
- College of Public Health, East Tennessee State University, Johnson City, TN, United States of America
| | - Meriam Ghardallou
- Department of Family and Community Medicine, University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
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Lanteigne A, Genest M, Racine E. The evaluation of pediatric-adult transition programs: What place for human flourishing? SSM - MENTAL HEALTH 2021. [DOI: 10.1016/j.ssmmh.2021.100007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Betz CL, Mannino JE, Disabato JA. Survey of US pediatric nurses' role in health care transition planning: Focus on assessment of self-management abilities of youth and young adults with long-term conditions. J Child Health Care 2021; 25:468-480. [PMID: 32870717 DOI: 10.1177/1367493520953649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The survival rates of youth and young adults (YYAs) diagnosed with long-term conditions have improved considerably as 90% now enter adulthood; health care transition planning (HCTP) has emerged as a nursing practice priority. The aim of this national online survey was to investigate the extent to which nurses, recruited from two major United States pediatric nursing organizations are involved with HCTP including assessing YYA self-management abilities (SMA). Findings of a 9-item assessment of self-management abilities subscale of the nurses' role in HTCP tool are reported. The nurse respondents (n = 1269), identified the most frequently assessed SMA was the YYAs' ability to understand and speak about their condition and its treatment (M = 2.3, SD = .89). The least frequently assessed was the YYAs' ability to identify community advocates to help them become more independent (M =1.5, SD = .90). Regression analysis identified significant predictors of the frequency nurses assess YYA for SMA included nurses' level of knowledge, perceived level of importance, HCTP and skills identified in job description, and caring for YYA. Findings indicate HCTP care advancements will necessitate HCTP training and development of nurse-led service efforts to facilitate optimal outcomes for YYA.
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Affiliation(s)
- Cecily L Betz
- Department of Pediatrics, Keck School of Medicine, University of Southern California, CA, USA
| | - Jennifer E Mannino
- Barbara H. Hagan School of Nursing, and Health Sciences 6957Molloy College, NY, USA
| | - Jennifer A Disabato
- College of Nursing and School of Medicine, 296427University of Colorado Anschutz Medical Campus, CO, USA
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Nursing's Influence on the Evolution of the Field of Health Care Transition and Future Implications. J Pediatr Health Care 2021; 35:408-413. [PMID: 34053794 DOI: 10.1016/j.pedhc.2021.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/07/2021] [Indexed: 11/20/2022]
Abstract
Health care transition (HCT) is an emerging field of practice and research with unlimited opportunities for nursing involvement. This article will highlight the unique contributions of nurse clinicians and researchers worldwide that have influenced HCT practice and research. The historical underpinnings of nursing practice will be discussed and feature the distinctive models and concepts of care that have and will continue to be contributed to HCT practice and research. Dimensions of prominent nursing contributions in collaboration with interdisciplinary partners as it pertains to scholarship, research, practice, and policymaking will be presented. The implications for future nursing involvement in this emerging field will be discussed.
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Understanding the Phenomenon of Health Care Transition: Theoretical Underpinnings, Exemplars of Nursing Contributions, and Research Implications. J Pediatr Health Care 2021; 35:310-316. [PMID: 33714671 DOI: 10.1016/j.pedhc.2020.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 11/21/2022]
Abstract
This manuscript features exemplars of nursing science that contribute to the development of health care transition practice models and evidence-based care. These research exemplars demonstrate the need for diverse investigative approaches coupled with clinical acumen and expertise in health care transition. The focus of describing nurse-led and nurse-contributory research and quality improvement efforts in this emerging field is offered to foster nursing involvement.Also, research efforts are not limited to the pediatric populations; research is needed for the provision of evidence-based careand monitoring of health and psychosocial outcomes of adults with childhood acquired chronic conditions.
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Roulin MJ, Jonniaux S, Guisado H, Séchaud L. Perceptions of inpatients and nurses towards the importance of nurses' caring behaviours in rehabilitation: A comparative study. Int J Nurs Pract 2020; 26:e12835. [PMID: 32207212 DOI: 10.1111/ijn.12835] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 12/24/2019] [Accepted: 02/22/2020] [Indexed: 11/29/2022]
Abstract
AIMS This study was conducted to describe and compare nurses' and inpatients' perceptions of caring attitudes and behaviours in rehabilitation. METHODS A comparative descriptive design was used. Perceptions of caring attitudes and behaviours were compared between 34 nurses working in rehabilitation and 64 elderly patients, using the Caring Nurse Patient Inventory-23, to explore Watson's carative factors through four dimensions. Patients' and nurses' ratings of importance for each dimension were compared. The study data were collected from 8 November 2017 to 5 May 2018. RESULTS Patients' and nurses' responses showed high scores in terms of their perceptions of caring, with nurses having the higher scores, and significant differences were found between patients and nurses. Patients scored items linked to clinical aspects of caring as the most important, whereas nurses scored items linked to humanistic and clinical caring as equally important. Comfort care was considered important for nurses and patients. Both groups considered relational caring items as the least important. CONCLUSION Results show that patients and nurses value clinical aspects of care, which is the visible aspect of care. The Caring Nurse Patient Inventory-23 is a reliable instrument to measure the nurses' and patients' perception of caring behaviours in rehabilitation.
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Affiliation(s)
| | | | - Huguette Guisado
- Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Geneva, Switzerland
| | - Laurence Séchaud
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
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Empowering Young Persons with Congenital Heart Disease: Using Intervention Mapping to Develop a Transition Program - The STEPSTONES Project. J Pediatr Nurs 2020; 50:e8-e17. [PMID: 31669495 DOI: 10.1016/j.pedn.2019.09.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 09/10/2019] [Accepted: 09/10/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE Describe the implementation of intervention mapping in the development of a transition program that aims to empower adolescents with congenital heart disease. DESIGN AND METHODS To gain a better understanding of the problem, we conducted a literature review, focus group and individual interviews, and a cross-sectional survey. This information helped us decide on the scope of the intervention, relevant theories, determinants, formulate performance and change objectives and identify adequate evidence-based change methods. Once the transition program had been designed, effectiveness and process evaluation studies were planned. RESULTS Young persons with congenital heart disease have insufficient disease-related knowledge, self-management skills and high parental involvement. The transition program involves three meetings with a trained transition coordinator over a two-and-a-half-year period and targets young persons with congenital heart disease and their parents. The transition coordinators use change techniques such as goal-setting, modeling and active learning in order to target three personal determinants (knowledge, self-efficacy and self-management). CONCLUSIONS The use of intervention mapping may lead to designing interventions tailored to the needs of the targeted population. The transition program described in this paper is currently being evaluated in a hybrid experimental design with simultaneous undertaking of the process evaluation. PRACTICE IMPLICATIONS This transition program can lead to the empowerment of young persons with congenital heart disease and help them in the process of becoming more responsible for their care. If proven effective, it can be implemented for other chronic conditions.
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Coyne I, Sheehan A, Heery E, While AE. Healthcare transition for adolescents and young adults with long-term conditions: Qualitative study of patients, parents and healthcare professionals' experiences. J Clin Nurs 2019; 28:4062-4076. [PMID: 31327174 DOI: 10.1111/jocn.15006] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 06/20/2019] [Accepted: 07/09/2019] [Indexed: 01/26/2023]
Abstract
AIM AND OBJECTIVES To examine the needs and perspectives regarding healthcare transition for adolescents and young adults (AYAs) with the following long-term conditions: diabetes, cystic fibrosis and congenital heart disease. BACKGROUND Transition of AYAs within healthcare services has become increasingly important as more children are surviving into adulthood with long-term conditions. Yet, limited empirical evidence exists regarding transition experiences. DESIGN Qualitative study fulfilling the completed consolidated criteria for reporting qualitative studies criteria (see Appendix S1). METHODS Semi-structured interviews with AYAs aged 14-25 years (n = 47), parents (n = 37) and health professionals (n = 32), which was part of a larger mixed-methods study. Sample was recruited from two children's hospitals and four general hospitals in Ireland. RESULTS Transfer occurred between the ages of 16-early 20s years depending on the service. None of the hospitals had a transition policy, and transition practices varied considerably. Adolescents worried about facing the unknown, communicating and trusting new staff and self-management. The transition process was smooth for some young adults, while others experienced a very abrupt transfer. Parents desired greater involvement in the transition process with some perceiving a lack of recognition of the importance of their role. In paediatric services, nurses reported following-up adolescents who struggled with treatment adherence and clinic attendance, whereas after transfer, little effort was made to engage young adults if there were lapses in care, as this was generally considered the young adults' prerogative. CONCLUSIONS The amount of preparation and the degree to which the shift in responsibility had occurred prior to transition appeared to influence successful transition for AYAs and their parents. RELEVANCE TO CLINICAL PRACTICE Nurses in collaboration with the multidisciplinary team can help AYAs develop their self-management skills and guide parents on how to relinquish responsibility gradually prior to transition.
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Affiliation(s)
- Imelda Coyne
- School of Nursing & Midwifery, Trinity College Dublin, Dublin 2, Ireland
| | - Aisling Sheehan
- School of Nursing & Midwifery, Trinity College Dublin, Dublin 2, Ireland
| | - Emily Heery
- School of Nursing & Midwifery, Trinity College Dublin, Dublin 2, Ireland
| | - Alison E While
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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Feo R, Conroy T, Wiechula R, Rasmussen P, Kitson A. Instruments measuring behavioural aspects of the nurse-patient relationship: A scoping review. J Clin Nurs 2019; 29:1808-1821. [PMID: 31162861 DOI: 10.1111/jocn.14947] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 04/18/2019] [Accepted: 05/15/2019] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To identify and map tools measuring behavioural aspects of the nurse-patient relationship. BACKGROUND The behaviours nurses employ to develop relationships with patients form a key part of nursing practice. Systematically measuring these behaviours provides an objective means of assessing and evaluating how nurses establish and maintain relationships with patients in a variety of settings. Whilst tools exist to measure these behaviours, little is known about their aims/scope, structure, method of development and contexts of use. Such knowledge is crucial for understanding the nature of the literature, including in which contexts and for which patient groups existing tools are suited. DESIGN Scoping review informed by Joanna Briggs Institute methodology. METHODS A database search was undertaken using CINAHL, PsycINFO, Pubmed and Embase. Primary research articles, theses and methodological papers that developed, refined and/or administered tools measuring behavioural aspects of the nurse-patient relationship, in any setting and for any patient group, were included. Tools had to measure actual not hypothetical behaviour (e.g., perceptions regarding importance). Data from included studies and tools were mapped. Results are reported in accordance with PRISMA-ScR guidelines. RESULTS One hundred and twenty-seven studies, containing 35 tools, were included. The literature was characterised by substantial variability, stemming from the continued refinement of tools (e.g., reduction to short forms) but also the development of new tools that appeared to duplicate existing work and the inconsistent use of tools across studies. CONCLUSIONS The volume of tools available demonstrates the importance of measuring the nurse-patient relationship. However, the existing duplication and variability create challenges in choosing amongst the tools available and show that, as a concept, the nurse-patient relationship remains poorly understood. RELEVANCE TO CLINICAL PRACTICE Research is required to synthesise, and assess the quality of, existing tools, enabling clinicians, leaders/managers, educators and researchers to administer appropriate tools to evaluate the nurse-patient relationship.
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Affiliation(s)
- Rebecca Feo
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Tiffany Conroy
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Rick Wiechula
- Adelaide Nursing School, University of Adelaide, Adelaide, South Australia, Australia
| | - Philippa Rasmussen
- Adelaide Nursing School, University of Adelaide, Adelaide, South Australia, Australia
| | - Alison Kitson
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
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White PH, Cooley WC, Boudreau ADA, Cyr M, Davis BE, Dreyfus DE, Forlenza E, Friedland A, Greenlee C, Mann M, McManus M, Meleis AI, Pickler L. Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home. Pediatrics 2018; 142:peds.2018-2587. [PMID: 30348754 DOI: 10.1542/peds.2018-2587] [Citation(s) in RCA: 415] [Impact Index Per Article: 69.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Risk and vulnerability encompass many dimensions of the transition from adolescence to adulthood. Transition from pediatric, parent-supervised health care to more independent, patient-centered adult health care is no exception. The tenets and algorithm of the original 2011 clinical report, "Supporting the Health Care Transition from Adolescence to Adulthood in the Medical Home," are unchanged. This updated clinical report provides more practice-based quality improvement guidance on key elements of transition planning, transfer, and integration into adult care for all youth and young adults. It also includes new and updated sections on definition and guiding principles, the status of health care transition preparation among youth, barriers, outcome evidence, recommended health care transition processes and implementation strategies using quality improvement methods, special populations, education and training in pediatric onset conditions, and payment options. The clinical report also includes new recommendations pertaining to infrastructure, education and training, payment, and research.
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Affiliation(s)
- Patience H. White
- Got Transition/The National Alliance to Advance Adolescent Health and Department of Medicine and Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia; and
| | - W. Carl Cooley
- Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
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