A81 BARRIERS AND FACILITATORS OF PEDIATRIC TO ADULT TRANSITION IN IBD: A PILOT STUDY EVALUATING THE STAKEHOLDER EXPERIENCE
Notice bibliographique
Résumé
Abstract Background Inflammatory bowel disease (IBD) is increasing in prevalence with up to 25% of IBD patients diagnosed before 18 years of age. These patients will require graduation from pediatric care to adult services. The transition of care from pediatric to adult gastroenterologists (GIs) is a purposeful transition that requires planning with involvement of all stakeholders to ensure proper transition and avoid interruption in care. Aims To identify the transition experiences of adult patients with pediatric diagnoses of IBD, their parents, pediatric and adult GIs and registered nurses (RNs) and identify barriers and facilitators to a successful transition. Methods Patients aged 18–25 diagnosed with pediatric-onset IBD were included. Semi-structured focus groups were held with 9 patients and separately with 4 parents. Questions focused on the patient transition experience, opportunities for improvement, and patient quality of life. Transition practices and expectations of 12 adult GIs, 7 pediatric GIs and 9 IBD nurses were also investigated in a series of provider specific focus groups. The groups were audio-recorded, transcribed and qualitative themes were noted. Results Patients: Facilitators included ease of access to adult providers outside of clinic time and parental presence in the early stages of transition. Barriers included abrupt transitions to adult care by age 18, lack of choice regarding adult GI and lack of adult nursing. Parents: Facilitators included an extended transition period, availability of support groups/resources. Barriers related to exclusion from the transition process and lack of input on adult GI choice. RNs: Facilitators include having champion IBD nurses on the pediatric and adult side during transition. Barriers included lack of educational tools for patients. Pediatric GIs: Facilitators included effective communication between adult and pediatric GIs, having an emergency assessment protocol, involving families in the transition process and access to multidisciplinary resources. Barriers included prolonged wait time for transfer and lack of adult access to multidisciplinary support. Adult GIs: Facilitators included succinct transfer summaries and formal transition programs for high risk patients. Barriers included a lack of multidisciplinary support, difficulty reaching rural areas, heavy case loads and prolonged wait time to transfer of care. Conclusions This study explores the stakeholder experience of pediatric to adult transition in IBD. Themes noted related to efficient communication between GIs, streamlining transfer summaries, ensuring a gradual transition process, involving parents and ensuring access to multidisciplinary resources. Identifying barriers and facilitators during the transition process can provide insight into creating a successful pediatric to adult transitions program in IBD. Funding Agencies None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,005 | 0,002 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,001 | 0,004 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».