面向青少年的家庭肠外营养创新教育计划,帮助他们 "过渡 "到成年期

JPGN reports Pub Date : 2024-01-25 DOI:10.1002/jpr3.12033
Olivier Goulet, E. Payen, C. Talbotec, C. Poisson, Amélia Rocha, Karina Brion, Marie‐Bernadette Madras, Isabelle Eicher, Isabelle Martinez, Clémence Bégo, Céline Chasport, Julie Ollivier, Cécile Godot, Claude Villain, Francisca Joly, C. Lambe
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引用次数: 0

摘要

面对日益增长的向成人护理管理过渡的需求,我们的家庭肠外营养(HPN)团队专门为长期使用 HPN 的青少年设计了一项青少年治疗教育计划(ATEP)。这项研究的目的是报告该计划的首期课程。ATEP计划在一年中的学校假期期间设计了连续五天的三期课程。其中包括导尿管操作、断开和连接 PN、导尿管包扎、处理突发事件(如发烧或导尿管损伤)等小组课程,还包括与心理学家、社会工作者、体育老师、时装专家的课程,以及与从小就接受 HPN 的成年人会面的课程。还为陪同的家长提供了专门课程。最后一次课程结束后六个月,在没有家长陪同的情况下,组织了一次为期 3 天的法国普瓦捷 "未来之镜 "游乐园之旅。经过 3 次 ATEP 培训后,共有 16 名青少年参加了培训,他们的年龄在 13 至 17 岁之间(中位数 14,IQR:14-16.25)。除了四名在中位数为 10 岁(IQR:1-10)时开始接受 PN 治疗的青少年外,其余所有青少年均在新生儿期开始接受长期 HPN 治疗。在进行 ATEP 时,他们的 PNDI 中位数为 105%(IQR:95.5-120.8),每周输液次数中位数为 6 次(IQR:5-7 次)。13名青少年接受了滔罗匹定锁定治疗。ATEP结束后,11名青少年可被视为完全自主,4名青少年可被视为部分自主,1名青少年未能获得任何自主权。青少年或家长对培训课程的评价从良好到优秀不等。通过这种全面、多专业的培训方法和团体凝聚力,青少年不仅能够处理导管护理和 PN 连接,还能更好地理解和接受自己的疾病,并预测自己的未来。
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An innovative educational program for adolescents on home parenteral nutrition for the “transition” to adulthood
Facing with an increasing demand for transition to adult care management, our home parenteral nutrition (HPN) team designed an adolescent therapeutic educational program (ATEP) specifically intended for adolescents on long‐term HPN. The aim of this study was to report on the first sessions of this program.The ATEP is designed in three sessions of five consecutive days, during school holidays over the year. It includes group sessions on catheter handling, disconnecting and connecting the PN and catheter dressing, dealing with unforeseen events (e.g., fever or catheter injury), but also sessions with psychologist, social worker, sports teacher, fashion specialist, meeting with adults who received HPN since childhood. Specific course for the accompanying parents were also provided. Six months after the last session, a 3‐day trip to the attraction park “le Futuroscope,” Poitiers, France, was organized without any parental presence.After 3 ATEP courses, a total of 16 adolescents have been enrolled. They were aged between 13 and 17 years (median 14 IQR: 14–16.25). All were on long term HPN started during the neonatal period except for four who started PN at a median age of 10 years old (IQR: 1–10). At the time of the ATEP, their median PNDI was 105% (IQR: 95.5–120.8) while receiving a median of six infusions per week (IQR: 5–7). Thirteen received Taurolidine lock procedure. After the ATEP, 11 adolescents could be considered as fully autonomous, 4 as partially autonomous and one failed to gain any autonomy. Course evaluation by adolescents or parents was good to excellent.Through the holistic and multiprofessional approach of this training and the group cohesion, the adolescents were not only able to handle catheter care and PN connections but were able to understand and accept better their illness and project themselves into their own future.
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