从儿科到成人护理的过渡对于患有脊柱裂(SB)的患者和家庭来说是具有挑战性的。终身护理关系产生于通常更大的新护理环境,不那么个人化,少参与SB护理的细微差别。由于独立于疾病或慢性医学复杂性的因素,青春期和成年期通常具有个人和心理压力。调查表明,转型与不确定性有关,焦虑,以及许多SB患者的不良事件风险升高。为了帮助缓解这种情况,作者制定了一项针对青少年SB患者和本科生/医学生的试验指导计划.本研究分析并介绍了该计划的初步结果。
作者创建了Join,团结,激励,并准备(JUMP)计划,以提高过渡过程的准备程度。受试者目标人群是在作者的SB诊所接受治疗的13-19岁患者。导师是经过筛选/批准的本科生/医学生,他们自愿参加并成功完成了在线指导培训。注册后,每个患者设置一个组合的临床,自我,以及使用个性化过渡计划的父母/监护人目标。这些目标与导师分享,学员,父母/监护人,和医生。为了监控成功,SB项目主任定期与每位导师会面,讨论取得的进展和增长领域。其中包括连续的定量和定性目标设定以及需要为每个议程解决的失败。
在9个月内创建了13个导师-导师匹配。在13场比赛中,6在初次会议后进行了5次以上的交流,还有一场导师-导师比赛今天仍在联系。众所周知,该计划的成功是通过受训者获得就业,申请奖学金,开始上大学,并与经历类似情况的其他人建立联系。由于在初次办公室访问后未能采取后续行动,出现了挑战,使用虚拟平台的风险,以及导师和受训者在整个作者州的广泛地理分散。
对于患有SB的青少年,从儿科到成人护理的过渡已被证明是一个很大的障碍。通过深思熟虑来缓解这个过程,交互过程有可能提高准备程度,增加患者的自主性,并提供与成人医疗保健社区的接触。然而,导师模式,在SB设置中,还没有被证明是补救措施。
The transition from pediatric to adult care is challenging for patients and families with spina bifida (SB). Lifelong care relationships yield to new care environments that are typically larger, less personal, and less engaged with the nuances of SB care. Adolescence and young adulthood are often characterized by personal and psychological stresses due to factors independent of illness or chronic medical complexity. Surveys have demonstrated that transition is associated with uncertainty, anxiety, and elevated risk of adverse events for many SB patients. To help mitigate this, the authors developed a trial mentorship program between teen patients with SB and undergraduate/medical students. This study analyzes and presents the initial outcomes from this program.
The authors created the Join, Unite, Motivate, and Prepare (JUMP) program to improve readiness for the transition process. The mentee target population was patients aged 13-19 years receiving care at the authors\' SB clinic. Mentors were screened/approved undergraduate/medical students who volunteered to participate and successfully completed online training in mentorship. Upon enrollment, each patient set a combination of clinical, self, and parent/guardian goals using the individualized transition plan. These goals were shared with the mentor, mentee, parent/guardian, and physician. To monitor success, the SB program director routinely met with each mentor to discuss progress made and areas of growth. These included continuous quantitative and qualitative goal setting and failures that needed to be addressed for each agenda.
Thirteen mentor-mentee matches were created over 9 months. Of the 13 matches, 6 had more than 5 communications after the initial meeting, and 1 mentor-mentee match is still in contact today. Noted success in the program has been through mentees gaining employment, applying for scholarships, starting college, and connecting with others who are going through similar circumstances. Challenges have arisen through failure to follow-up after the initial office visit, risk with using the virtual platform, and wide geographic dispersion of both mentors and mentees across the authors\' state.
Transition from pediatric to adult care for adolescents with SB has proven to be a large hurdle. Easing this process through well-thought-out, interactive processes has the potential to improve readiness, increase patient autonomy, and provide exposure to the adult healthcare community. However, the mentorship model, in the SB setting, has not proven to be the remedy.