Adult Congenital Heart Care in a Pediatric Setting-A Patient's Perspective

Readiness for transition from pediatric to adult care for adolescents with chronic heart disease

PURPOSE

The purpose of this study was to determine transition readiness of adolescents with chronic heart disease to adult care.

METHODS

The sample of the study comprised 113 adolescents between the ages 12 and 18 years with chronic heart disease. Transition readiness was assessed by the Transition-Q self-administered tool.

RESULTS

The Transition-Q mean score was 63.0 (range = 31-92). The self-management skills of the adolescents increased significantly in direct proportion to their ages. Most of the adolescents had a lack of confidence about medication management and communicating with healthcare providers. No significant difference was detected between boys and girls in terms of total and individual items' scores.

PRACTICE IMPLICATIONS

Transition readiness should be assessed to understand transitional requirements of adolescents with chronic heart disease and to plan appropriate nursing interventions accordingly.

Peri-operative care in adults with congenital heart disease: room for improvement in after care

BACKGROUND

Patient satisfaction with care has received little attention within the field of congenital heart disease. Our objective was to examine patient satisfaction with the care received when undergoing open-heart surgery in order to identify the best and worst aspects of peri-operative care. Moreover, we examined whether having contact with a specialised nurse in addition to usual care is associated with higher patient satisfaction levels.

METHODS

Patient satisfaction was measured by the Satisfaction with Hospital Care Questionnaire, evaluating nine aspects of care by answering individual items and giving overall grades. A top 10 of the best and worst items was selected. Linear regression analyses were used to examine the relationship between having contact with a specialised nurse and patient satisfaction (9 grades), independent of patient characteristics--sex, age, educational level, and health status.

RESULTS

Data were available for 75 patients. Grades ranged from 6.74 for "discharge and after care" to 8.18 for "medical care". In all, 21% of patients were dissatisfied with the clarity of the information about lifestyle adjustments given by the surgeon. However, patients who had contact with a specialised nurse were more satisfied with the provided information (B-coefficient is 0.497, p-value is 0.038), independent of patient characteristics.

CONCLUSIONS

Patients were satisfied with the received care, although there is room for improvement, especially in discharge and after care and the clarity of the information provided by the surgeon. This gap in care can be compensated for by specialised nurses, as patients who were counselled by a specialised nurse were more satisfied with the provided information.