BACKGROUND Transfer from a pediatric to an adult medical setting is associated with many barriers. Additionally, there are little data on patients' assessment of the transition process itself. 3 years ago at Lurie Children's Hospital of Chicago, we established a kidney transition program with the help of an adult nephrologist, physician assistant (PA) and social worker (LCSW). After 18 months, we evaluated the patients' perception of the program as part of a continuous quality initiative process. METHODS Patients who had transitioned from pediatric care and were seen at least once in the adult nephrology clinic were anonymized and asked to take an established 5-point Likert scale survey. Survey questions addressed readiness to transition, the transition process itself, and the perception of adult care. Surveys were followed with semi-structured interviews. 3 readers rated each response as either "negative," "neutral," or "positive." Average, standard deviation and reader reliability were calculated. The readers also selected a word that best depicted each response and those most-common words were counted by question and overall. RESULTS 17 out of 42 patients (40%) completed the survey. Average age at transition (mean + SD) was 20 + 2 years; the majority of patients (82%) felt ready to transfer to adult care but only 59% felt they were consulted on the timing. 88% of patients felt having a transition appointment and meeting the adult care providers in the pediatric setting to be valuable. Although 94% of patients ultimately felt comfortable in the adult care environment, 18% experienced noticeable differences in treatment recommendations. 13 semi-structured interviews were conducted. Overall, the patients responded positively (3 + 0, 100% reader reliability) to the transition. But, when asked what could have improved the transition, the word the patients used most was, "earlier." CONCLUSION Young adults (YA) transitioning to adult care often feel ready to transition earlier than their transfer of care date. They subjectively benefit from a transition program that outlines the process of transferring their care. Many YA patients would benefit from a transition program that bolsters patient independence during early adult care visits.

中文翻译：

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评估年轻人从小儿向成年肾脏实践过渡的成功。

背景技术从儿科到成人医疗环境的转移与许多障碍有关。此外，关于患者对过渡过程本身的评估的数据很少。3年前，我们在成年肾脏病学家，医师助理（PA）和社会工作者（LCSW）的帮助下，在芝加哥卢里儿童医院建立了肾脏移植计划。18个月后，我们评估了患者对计划的感知，并将其作为持续质量计划过程的一部分。方法从儿科护理过渡到成年肾脏病诊所至少看过一次的患者匿名，并要求进行既定的5点Likert量表调查。调查问题涉及过渡的准备情况，过渡过程本身以及对成人照料的看法。调查之后进行半结构化访谈。3位读者将每个回答评为“否定”，“中立”或“肯定”。计算平均值，标准差和阅读器可靠性。读者还选择了一个最能描绘每个回答的单词，然后按问题和总体来计算最常见的单词。结果42例患者中有17例（40％）完成了调查。平均过渡年龄（平均+标准差）为20 + 2岁；大多数患者（82％）感到准备好转为成人护理，但只有59％的患者感到接受了时机咨询。88％的患者觉得有个过渡期约会并与小儿科环境中的成人护理提供者会很有价值。尽管94％的患者最终在成人护理环境中感到舒适，18％的治疗建议存在明显差异。进行了13次半结构化访谈。总体而言，患者对该过渡反应积极（3 + 0，读者可靠性100％）。但是，当被问到什么可以改善过渡时，患者使用最多的单词是“较早”。结论过渡到成人照料的年轻成年人（YA）常常比他们的照护日期更早准备好过渡。从主观上，他们将从过渡计划中受益，该计划概述了他们的护理转移过程。许多YA患者将从过渡计划中受益，该计划可增强早期成人护理就诊期间的患者独立性。当被问到什么可以改善过渡时，患者使用最多的单词是“较早”。结论过渡到成人照料的年轻成年人（YA）常常比他们的照护日期更早准备好过渡。从主观上，他们将从过渡计划中受益，该计划概述了他们的护理转移过程。许多YA患者将从过渡计划中受益，该计划可增强早期成人护理就诊期间的患者独立性。当被问到什么可以改善过渡时，患者使用最多的单词是“较早”。结论过渡到成人照料的年轻成年人（YA）常常比他们的照护日期更早准备好过渡。从主观上，他们将从过渡计划中受益，该计划概述了他们的护理转移过程。许多YA患者将从过渡计划中受益，该计划可增强早期成人护理就诊期间的患者独立性。