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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的关心连续性：一个现实的评估研究

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Objectives: To identify the continuity mechanisms central to a smooth transition from child to adult diabetes care, the service components through which these can be achieved and their inter-relations in different contexts. Methods: A realistic evaluation study of five models of transition in England comprising: organizational analysis (semi-structured interviews with 38 health care professionals and selected observations); case studies of 46 young people under-going transition and 39 carers (three qualitative interviews over a 12-18 month period, medical record review and clinical interviews); surveys of 82 (32% response rate at least once and 11% response rate at two time points) young people in the population approaching, undergoing or less than 12 months post-transition, and their carers (questionnaires included psychosocial outcome measures); and a costs and consequences analysis. Results: Seven continuities contribute to smooth transition: relational, longitudinal, management, informational, flexible, developmental and cultural. Relational, longitudinal, flexible and cultural continuity are the most important. Models with high levels of relational, longitudinal, flexible and cultural continuity achieve smooth transition with relatively informal, low-cost informational and management continuity mechanisms. Models with low levels of relational and longitudinal continuity need to invest in more formal interventions to facilitate management, flexible and informational continuity so that smooth transition is not compromised. Conclusions: Focusing on continuity mechanisms, their inter-relations and the effectiveness of different constellations of service components in achieving smooth transition has furnished evidence to inform the development of innovative models which build on the logic of these findings but are sensitive to local context. Further studies are needed to confirm the quantitative findings from a broader range of services and patients.
机译：目标：确定与儿童对成人糖尿病护理的平滑过渡的连续性机制，可以实现这些的服务组件以及它们在不同背景下的关系。方法：英格兰五种过渡模型的现实评价研究，包括：组织分析（半结构化访谈与38名医疗专业人员和选定观察）;案例研究46名年轻人出现过渡和39名护理人员（在12-18个月期间的三个定性访谈，医疗记录审查和临床访谈）; 52（32％的反应率至少一次和11％的响应率为11％）的人口中的青少年接近，接近或少于12个月，以及他们的护理人员（调查问卷包括心理社会结果措施）;以及成本和后果分析。结果：七个连续性有助于平滑过渡：关系，纵向，管理，信息，灵活，发展和文化。关系，纵向，灵活，文化连续性是最重要的。具有高度关系，纵向，灵活和文化连续性的模型实现了相对非正式，低成本的信息和管理连续性机制的平滑过渡。具有低级别和纵向连续性的模型需要投资更正式的干预措施，以促进管理，灵活和信息性的连续性，使得平稳过渡不会受到损害。结论：重点关注连续性机制，他们的关系和不同星座的服务部件在实现顺利过渡方面的效力使得提供了证据，以便于开发创新模型，这些模型在这些发现的逻辑上建立，而是对本地背景敏感。需要进一步的研究来确认来自更广泛的服务和患者的定量发现。

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    AllenD.; CohenD.; HoodK.; RoblingM.; AtwellC.; LaneC.; LowesL.; ChannonS.; GillespieD.; GrovesS.; HarveyJ.; GregoryJ.;

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    Cardiff School of Nursing and Midwifery Studies Cardiff University East Gate House 35-43 Newport;

    Health Economics and Policy Research Unit Faculty of Health Sport and Science University of;

    Department of Primary Care and Public Health School of Medicine Cardiff University Cardiff;

    Department of Primary Care and Public Health School of Medicine Cardiff University Cardiff;

    Cardiff School of Nursing and Midwifery Studies Cardiff University East Gate House 35-43 Newport;

    Cardiff School of Nursing and Midwifery Studies Cardiff University East Gate House 35-43 Newport;

    Cardiff School of Nursing and Midwifery Studies Cardiff University East Gate House 35-43 Newport;

    Cardiff and Vale University Health Board Cardiff United Kingdom;

    Department of Primary Care and Public Health School of Medicine Cardiff University Cardiff;

    Health Economics and Policy Research Unit Faculty of Health Sport and Science University of;

    Endocrinology and Metabolism Centre for Endocrinology and Diabetes Sciences Cardiff University;

    Department of Child Health Wales School of Medicine Cardiff University Cardiff United Kingdom;

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  • 正文语种 eng
  • 中图分类 预防医学、卫生学;
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