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首页> 外文期刊>Journal of Health Services Research _Policy >Continuity of care in the transition from child to adult diabetes services: a realistic evaluation study
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Continuity of care in the transition from child to adult diabetes services: a realistic evaluation study

机译：从儿童到成人糖尿病服务过渡期间的护理连续性：一项现实的评估研究

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the service components through which these can be achieved and their inter-relations in different contexts.nMethods: A realistic evaluation study of five models of transition in England comprising: organizationalnanalysis (semi-structured interviews with 38 health care professionals and selected observations); case studiesnof 46 young people under-going transition and 39 carers (three qualitative interviews over a 12–18 monthnperiod, medical record review and clinical interviews); surveys of 82 (32% response rate at least once andn11% response rate at two time points) young people in the population approaching, undergoing or less thann12 months post-transition, and their carers (questionnaires included psychosocial outcome measures); and ancosts and consequences analysis.nResults: Seven continuities contribute to smooth transition: relational, longitudinal, management, informational,nflexible, developmental and cultural. Relational, longitudinal, flexible and cultural continuity are the mostnimportant. Models with high levels of relational, longitudinal, flexible and cultural continuity achieve smoothntransition with relatively informal, low-cost informational and management continuity mechanisms. Models withnlow levels of relational and longitudinal continuity need to invest in more formal interventions to facilitatenmanagement, flexible and informational continuity so that smooth transition is not compromised.nConclusions: Focusing on continuity mechanisms, their inter-relations and the effectiveness of differentnconstellations of service components in achieving smooth transition has furnished evidence to inform thendevelopment of innovative models which build on the logic of these findings but are sensitive to local context.nFurther studies are needed to confirm the quantitative findings from a broader range of services and patients
机译：n方法：对英格兰五种过渡模式的现实评估研究，包括：组织分析（与38位医疗保健专业人员进行的半结构式访谈和部分观察结果）；案例研究：46名正在过渡的年轻人和39名护理人员（在12至18个月的时间内进行了3次定性访谈，病历审查和临床访谈）；调查了接近过渡期，正在接受过渡或少于过渡后12个月的82名年轻人（至少一次回应率为32％，两个时间点回应率为11％）及其照顾者（问卷调查包括心理社会结果指标）;结果：七个连续性有助于平稳过渡：关系，纵向，管理，信息，不灵活，发展和文化。关系，纵向，弹性和文化的连续性是最重要的。具有高水平的关系，纵向，弹性和文化连续性的模型可以使用相对非正式，低成本的信息和管理连续性机制来实现平稳过渡。关系和纵向连续性水平较低的模型需要投资于更正式的干预措施，以促进管理，灵活和信息连续性，从而不损害平稳过渡。n结论：着眼于连续性机制，它们之间的相互关系以及不同服务群的有效性。实现平稳过渡为随后基于这些发现的逻辑但对当地情况敏感的创新模型的开发提供了证据。需要进一步的研究以确认来自更广泛的服务和患者的定量发现

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