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Changes over time in self-efficacy and the allocation of responsibility for health management tasks in pediatric liver transplant recipients: Targets to improve the transition process.
Bilhartz, Jacob L; Lopez, M James; Eder, Sally J; Magee, John C; Rea, Kelly; Sturza, Julie; Fredericks, Emily M.
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  • Bilhartz JL; Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA.
  • Lopez MJ; University of Michigan Transplant Center, Michigan Medicine, Ann Arbor, Michigan, USA.
  • Eder SJ; Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA.
  • Magee JC; University of Michigan Transplant Center, Michigan Medicine, Ann Arbor, Michigan, USA.
  • Rea K; Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA.
  • Sturza J; University of Michigan Transplant Center, Michigan Medicine, Ann Arbor, Michigan, USA.
  • Fredericks EM; Department of Surgery, Michigan Medicine, Ann Arbor, Michigan, USA.
Pediatr Transplant ; 28(1): e14673, 2024 Feb.
Article en En | MEDLINE | ID: mdl-38059409
BACKGROUND: The process of transition to adult-based care encompasses a critical period in the life of an adolescent and young adult living with a chronic illness and one that comes with an increase in the risk of poor health outcomes. As yet, there is a dearth of empirical data to help optimize this process to ensure the best long-term outcome. METHODS: This study used a principal components analysis to determine specific constructs measured by a revised version of the transition readiness survey used in our clinic. We investigated changes in these constructs over time. We further investigated the relationship between the change in these constructs over time spent in a focused transition program with adherence. RESULTS: The primary component underlying our transition readiness survey for patients and parents represented self-efficacy. Time spent in the transition program was an independent predictor of change in self-efficacy (rho 0.299, p = .015); however, the magnitude of that change had no relationship to adherence. Change in parent-proxy self-efficacy was found to have a statistically significant relationship with tacrolimus standard deviation (rho -0.301, p = .026). There was disagreement identified between patient and parent responses on the survey. Neither change in patient nor parent reports of self-efficacy was found to have a relationship with post-transfer adherence. CONCLUSIONS: This study reaches the novel conclusion that self-efficacy and parent-proxy self-efficacy are dynamic concepts that change over time spent in a focused transition program. The patient-parent disagreement and the relationship between parent-proxy self-efficacy and adherence stress the importance of involving parents/guardians in the transition process as well.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Hígado / Transición a la Atención de Adultos Límite: Adolescent / Adult / Child / Humans Idioma: En Revista: Pediatr Transplant Asunto de la revista: PEDIATRIA / TRANSPLANTE Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Dinamarca
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Hígado / Transición a la Atención de Adultos Límite: Adolescent / Adult / Child / Humans Idioma: En Revista: Pediatr Transplant Asunto de la revista: PEDIATRIA / TRANSPLANTE Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Dinamarca