Experiences of health care transition voiced by young adults with type 1 diabetes: a qualitative study

作者：Katharine C. Garvey, M. Beste, Donna F. Luff, Astrid Atakov-Castillo, Howard A. Wolpert, Marilyn D. Ritholz · 发表于：Adolescent Health Medicine and Therapeutics · 年份：2014 · DOI：10.2147/ahmt.s67943 · 被引用次数：88 · 研究领域：Adolescent and Pediatric Healthcare、Diabetes Management and Research、Infant Development and Preterm Care

OBJECTIVE: This qualitative study aimed to explore the experience of transition from pediatric to adult diabetes care reported by posttransition emerging adults with type 1 diabetes (T1D), with a focus on preparation for the actual transfer in care. METHODS: Twenty-six T1D emerging adults (mean age 26.2±2.5 years) receiving adult diabetes care at a single center participated in five focus groups stratified by two levels of current glycemic control. A multidisciplinary team coded transcripts and conducted thematic analysis. RESULTS: FOUR KEY THEMES ON THE PROCESS OF TRANSFER TO ADULT CARE EMERGED FROM A THEMATIC ANALYSIS: 1) nonpurposeful transition (patients reported a lack of transition preparation by pediatric providers for the transfer to adult diabetes care); 2) vulnerability in the college years (patients conveyed periods of loss to follow-up during college and described health risks and diabetes management challenges specific to the college years that were inadequately addressed by pediatric or adult providers); 3) unexpected differences between pediatric and adult health care systems (patients were surprised by the different feel of adult diabetes care, especially with regards to an increased focus on diabetes complications); and 4) patients' wish list for improving the transition process (patients recommended enhanced pediatric transition counseling, implementation of adult clinic orientation programs, and peer support for transitioning patients). CONCLUSION: Our find...