Mixed-methods evaluation of a transition and young adult clinic for kidney transplant recipients.
Identifieur interne : 000502 ( Main/Exploration ); précédent : 000501; suivant : 000503Mixed-methods evaluation of a transition and young adult clinic for kidney transplant recipients.
Auteurs : Vanessa Michaud [Canada] ; Marie Achille [Canada] ; Fanie Chainey [Canada] ; Véronique Phan [Canada] ; Catherine Girardin [Canada] ; Marie-José Clermont [Canada]Source :
- Pediatric transplantation [ 1399-3046 ] ; 2019.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Adulte (MeSH), Autorapport (MeSH), Défaillance rénale chronique (chirurgie), Défaillance rénale chronique (psychologie), Enquêtes et questionnaires (MeSH), Humains (MeSH), Immunosuppresseurs (sang), Jeune adulte (MeSH), Mâle (MeSH), Observance par le patient (MeSH), Période postopératoire (MeSH), Qualité de vie (MeSH), Recherche qualitative (MeSH), Résultat thérapeutique (MeSH), Soutien social (MeSH), Tacrolimus (sang), Transition aux soins pour adultes (MeSH), Transplantation rénale (MeSH).
- MESH :
- chirurgie : Défaillance rénale chronique.
- psychologie : Défaillance rénale chronique.
- sang : Immunosuppresseurs, Tacrolimus.
- Adolescent, Adulte, Autorapport, Enquêtes et questionnaires, Humains, Jeune adulte, Mâle, Observance par le patient, Période postopératoire, Qualité de vie, Recherche qualitative, Résultat thérapeutique, Soutien social, Transition aux soins pour adultes, Transplantation rénale.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Humans (MeSH), Immunosuppressive Agents (blood), Kidney Failure, Chronic (psychology), Kidney Failure, Chronic (surgery), Kidney Transplantation (MeSH), Male (MeSH), Patient Compliance (MeSH), Postoperative Period (MeSH), Qualitative Research (MeSH), Quality of Life (MeSH), Self Report (MeSH), Social Support (MeSH), Surveys and Questionnaires (MeSH), Tacrolimus (blood), Transition to Adult Care (MeSH), Treatment Outcome (MeSH), Young Adult (MeSH).
- MESH :
- chemical , blood : Immunosuppressive Agents, Tacrolimus.
- psychology : Kidney Failure, Chronic.
- surgery : Kidney Failure, Chronic.
- Adolescent, Adult, Humans, Kidney Transplantation, Male, Patient Compliance, Postoperative Period, Qualitative Research, Quality of Life, Self Report, Social Support, Surveys and Questionnaires, Transition to Adult Care, Treatment Outcome, Young Adult.
Abstract
The aims of the present study were to describe the experiences of kidney transplant patients attending a young adult clinic or a regular adult clinic, to explore similarities and differences between the groups, and to conduct an evaluation of the clinical and psychosocial outcomes of the young adult clinic, by comparing these outcomes to those of the regular adult clinic. A mixed-methods design combining qualitative and quantitative data was used. Empirically validated questionnaires measuring self-determination theory variables, quality of life, and adherence were distributed to all consenting patients attending the YAC (n = 17) and RAC (n = 16). Semi-structured interviews were conducted with a subsample of the first (n = 10) and second group (n = 8), and analyzed using thematic analysis. Clinical outcomes were retrieved from medical records. Descriptive, correlational, and comparative analyses were performed. We found clinically significant differences on tacrolimus blood levels variability, self-reported adherence, and physical quality of life. Small and medium effect sizes were detected. No statistical differences were found. Statistically significant correlations were found between self-determination theory variables and both physical quality of life and different measures of adherence. Four themes characterized patients' experiences: resilience; relational needs and the therapeutic alliance; quest for balance; and quest for normalcy. The young adult clinic seems to meet its initial objectives and to make a difference particularly in the early period post-transition, but over time what matters most for patients is therapeutic alliance. Mental health issues need to be better addressed, and special attention should be paid to youths transplanted in an adult setting.
DOI: 10.1111/petr.13450
PubMed: 31062926
Affiliations:
Links toward previous steps (curation, corpus...)
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xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Autorapport</term><term>Enquêtes et questionnaires</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Observance par le patient</term><term>Période postopératoire</term><term>Qualité de vie</term><term>Recherche qualitative</term><term>Résultat thérapeutique</term><term>Soutien social</term><term>Transition aux soins pour adultes</term><term>Transplantation rénale</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aims of the present study were to describe the experiences of kidney transplant patients attending a young adult clinic or a regular adult clinic, to explore similarities and differences between the groups, and to conduct an evaluation of the clinical and psychosocial outcomes of the young adult clinic, by comparing these outcomes to those of the regular adult clinic. A mixed-methods design combining qualitative and quantitative data was used. Empirically validated questionnaires measuring self-determination theory variables, quality of life, and adherence were distributed to all consenting patients attending the YAC (n = 17) and RAC (n = 16). Semi-structured interviews were conducted with a subsample of the first (n = 10) and second group (n = 8), and analyzed using thematic analysis. Clinical outcomes were retrieved from medical records. Descriptive, correlational, and comparative analyses were performed. We found clinically significant differences on tacrolimus blood levels variability, self-reported adherence, and physical quality of life. Small and medium effect sizes were detected. No statistical differences were found. Statistically significant correlations were found between self-determination theory variables and both physical quality of life and different measures of adherence. Four themes characterized patients' experiences: resilience; relational needs and the therapeutic alliance; quest for balance; and quest for normalcy. The young adult clinic seems to meet its initial objectives and to make a difference particularly in the early period post-transition, but over time what matters most for patients is therapeutic alliance. Mental health issues need to be better addressed, and special attention should be paid to youths transplanted in an adult setting.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">31062926</PMID><DateCompleted><Year>2020</Year><Month>04</Month><Day>21</Day></DateCompleted><DateRevised><Year>2020</Year><Month>04</Month><Day>21</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1399-3046</ISSN><JournalIssue CitedMedium="Internet"><Volume>23</Volume><Issue>4</Issue><PubDate><Year>2019</Year><Month>06</Month></PubDate></JournalIssue><Title>Pediatric transplantation</Title><ISOAbbreviation>Pediatr Transplant</ISOAbbreviation></Journal><ArticleTitle>Mixed-methods evaluation of a transition and young adult clinic for kidney transplant recipients.</ArticleTitle><Pagination><MedlinePgn>e13450</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/petr.13450</ELocationID><Abstract><AbstractText>The aims of the present study were to describe the experiences of kidney transplant patients attending a young adult clinic or a regular adult clinic, to explore similarities and differences between the groups, and to conduct an evaluation of the clinical and psychosocial outcomes of the young adult clinic, by comparing these outcomes to those of the regular adult clinic. A mixed-methods design combining qualitative and quantitative data was used. Empirically validated questionnaires measuring self-determination theory variables, quality of life, and adherence were distributed to all consenting patients attending the YAC (n = 17) and RAC (n = 16). Semi-structured interviews were conducted with a subsample of the first (n = 10) and second group (n = 8), and analyzed using thematic analysis. Clinical outcomes were retrieved from medical records. Descriptive, correlational, and comparative analyses were performed. We found clinically significant differences on tacrolimus blood levels variability, self-reported adherence, and physical quality of life. Small and medium effect sizes were detected. No statistical differences were found. Statistically significant correlations were found between self-determination theory variables and both physical quality of life and different measures of adherence. Four themes characterized patients' experiences: resilience; relational needs and the therapeutic alliance; quest for balance; and quest for normalcy. The young adult clinic seems to meet its initial objectives and to make a difference particularly in the early period post-transition, but over time what matters most for patients is therapeutic alliance. Mental health issues need to be better addressed, and special attention should be paid to youths transplanted in an adult setting.</AbstractText><CopyrightInformation>© 2019 Wiley Periodicals, Inc.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Michaud</LastName><ForeName>Vanessa</ForeName><Initials>V</Initials><Identifier Source="ORCID">0000-0002-2563-5825</Identifier><AffiliationInfo><Affiliation>Department of Psychology, Université de Montréal, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Achille</LastName><ForeName>Marie</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Psychology, Université de Montréal, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chainey</LastName><ForeName>Fanie</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Psychology, Université de Montréal, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Phan</LastName><ForeName>Véronique</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Department of Pediatric Nephrology, CHU Sainte-Justine, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Girardin</LastName><ForeName>Catherine</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Clermont</LastName><ForeName>Marie-José</ForeName><Initials>MJ</Initials><AffiliationInfo><Affiliation>Department of Pediatric Nephrology, CHU Sainte-Justine, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>05</Month><Day>07</Day></ArticleDate></Article><MedlineJournalInfo><Country>Denmark</Country><MedlineTA>Pediatr Transplant</MedlineTA><NlmUniqueID>9802574</NlmUniqueID><ISSNLinking>1397-3142</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007166">Immunosuppressive Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>WM0HAQ4WNM</RegistryNumber><NameOfSubstance UI="D016559">Tacrolimus</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007166" MajorTopicYN="N">Immunosuppressive Agents</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007676" MajorTopicYN="N">Kidney Failure, Chronic</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016030" MajorTopicYN="Y">Kidney Transplantation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010349" MajorTopicYN="N">Patient Compliance</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011184" MajorTopicYN="N">Postoperative Period</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D036301" MajorTopicYN="N">Qualitative Research</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011788" MajorTopicYN="N">Quality of Life</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D057566" MajorTopicYN="N">Self Report</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012944" MajorTopicYN="N">Social Support</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016559" MajorTopicYN="N">Tacrolimus</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D060305" MajorTopicYN="Y">Transition to Adult Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">adherence</Keyword><Keyword MajorTopicYN="Y">kidney transplant</Keyword><Keyword MajorTopicYN="Y">mixed-methods evaluation</Keyword><Keyword MajorTopicYN="Y">outcomes</Keyword><Keyword MajorTopicYN="Y">pediatric</Keyword><Keyword MajorTopicYN="Y">psychosocial</Keyword><Keyword MajorTopicYN="Y">transition</Keyword><Keyword MajorTopicYN="Y">young adult clinic</Keyword><Keyword MajorTopicYN="Y">youth</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>10</Month><Day>16</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2019</Year><Month>03</Month><Day>07</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>04</Month><Day>01</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>5</Month><Day>8</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>4</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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sort="Girardin, Catherine" uniqKey="Girardin C" first="Catherine" last="Girardin">Catherine Girardin</name><name sortKey="Phan, Veronique" sort="Phan, Veronique" uniqKey="Phan V" first="Véronique" last="Phan">Véronique Phan</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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