10~19岁慢性病患者向成人过渡期准备度评估工具的系统评价

doi:10.3761/j.issn.0254-1769.2025.04.013

摘要/Abstract

摘要：

目的对国内外10~19岁青少年慢性病患者向成人过渡期准备度评估工具进行系统评价，为医护人员选择合适的工具提供参考。方法系统检索中国知网、万方数据库、中国生物医学文献服务系统、PubMed、Web of Science、Embase和Cochrane Library，收集青少年慢性病患者向成人过渡期准备度评估工具相关文献，检索时限为建库至2024年8月。由2名研究者独立筛选文献、提取资料，并使用基于共识的健康测量工具遴选标准对评估工具进行系统评价，形成推荐意见。结果纳入29篇文献，共涉及9项普适性评估工具和5项特异性评估工具。其中，过渡准备评估问卷的结构效度和内部一致性评价为“充分”，为A级推荐；“我准备好过渡到成人护理了吗”调查问卷、过渡期状态评估问卷、癫痫患者过渡准备评估量表和风湿病成人护理准备情况评估工具为C级推荐，其余工具均为B级推荐。结论青少年慢性病患者向成人过渡期准备度评估工具较多，推荐使用过渡准备评估问卷，其余工具仍需进一步验证。

关键词: 青少年, 慢性病, 过渡期准备, 评估工具, 测量学特性, 系统评价, 儿科护理学

Abstract:

Objective To systematically evaluate the assessment tools of adolescent chronic disease patients’ transition readiness to adults at home and abroad，and to provide references for medical personnel to choose appropriate tools. Methods CNKI，Wan Fang Data，CBM，PubMed，Web of Science，Embase and Cochrane were searched for literature related to the assessment tools of transition readiness in adolescents with chronic illnesses to adulthood from inception to August，2024. Literature screening and data extraction of the tools were extracted independently by 2 researchers. At the same time，the criteria for the selection of health measurement tools based on consensus（COSMIN） systematic evaluation guidelines were used to evaluate the inclusion assessment tools，and recommendations were finally formed. Results A total of 29 articles were included，involving 9 universal and 5 specific assessment tools of adolescent chronic illnesses transition readiness. The Transition Readiness Assessment Questionnaire has satisfactory content validity and internal consistency，and it is recommended as Grade A. The Grade C included the Am I ON TRAC for adult care? Questionnaire and the State Assessment Questionnaire for Transition，Epilepsy-specific Transition Readiness Assessment Questionnaire and the Readiness for Adult Care in Rheumatology，while the others are recommended as Grade B. Conclusion There are a variety of tools to assess the transition readiness of adolescents with chronic diseases to adults，and there are few tools suitable for adolescents with chronic diseases in China，with few specific tools. After comprehensive consideration，the Transition Readiness Assessment Questionnaire can be recommended temporarily.

Key words: Adolescent, Chronic Disease, Transition Readiness, Assessment Tools, Measurement Properties, Systematic Review, Pediatric Nursing

王飒, 苗华丽, 李雨蔚, 王鸿伟, 乔彩彩, 宋炜婷. 10~19岁慢性病患者向成人过渡期准备度评估工具的系统评价[J]. 中华护理杂志, 2025, 60(4): 469-477.

WANG Sa, MIAO Huali, LI Yuwei, WANG Hongwei, QIAO Caicai, SONG Weiting. A systematic review of tools for assessing the readiness of patients with chronic diseases aged 10-19 to transition to adulthood[J]. Chinese Journal of Nursing, 2025, 60(4): 469-477.

图/表 5

表1 PubMed检索策略

Table 1 PubMed search strategy

图1 文献检索流程

Figure 1 Literature screening process

表2 纳入文献的基本特征（n=29）

Table 2 The basic characteristics of the included assessment studies（n=29）

表3 纳入评估工具的方法学质量和测量学属性评价结果（n=29）

Table 3 Evaluation of the methodological quality and the measurement properties of the included tools（n=29）

表4 纳入评估工具测量学属性的总体评价及推荐等级（n=14）

Table 4 Evaluation of the psychometric properties and recommendations for inclusion in the assessment tools（n=14）

参考文献 35

[1]	江思思, 任丽亚, 王宇鑫, 等. 慢性病患儿心理行为适应特征的潜在类别分析[J]. 中华护理杂志, 2022, 57(14):1717-1724. DOI URL
	Jiang SS, Ren LY, Wang YX, et al. Latent class analysis of psychological behavior adaption among children with chronic diseases[J]. Chin J Nurs, 2022, 57(14):1717-1724. DOI URL
[2]	Rosen DS, Blum RW, Britto M, et al. Transition to adult health care for adolescents and young adults with chronic conditions:position paper of the Society for Adolescent Medicine[J]. J Ado-lesc Health, 2003, 33(4):309-311.
[3]	巩格言, 马佳莉, 高雯颖, 等. 慢性病青少年及照护者双视角下成长过渡期准备的纵向研究[J]. 中华护理杂志, 2022, 57(16):1969-1975.
	Gong GY, Ma JL, Gao WY, et al. The influence of family management adjustment and the trajectory of transition rea-diness in adolescents with chronic diseases and caregivers on their quality of life[J]. Chin J Nurs, 2022, 57(16):1969-1975.
[4]	Sawicki GS, Lukens-Bull K, Yin XP, et al. Measuring the tran-sition readiness of youth with special healthcare needs:validation of the TRAQ:Transition Readiness Assessment Ques-tionnaire[J]. J Pediatr Psychol, 2011, 36(2):160-171.
[5]	Prinsen CAC, Mokkink LB, Bouter LM, et al. COSMIN guideline for systematic reviews of patient-reported outcome measures[J]. Qual Life Res, 2018, 27(5):1147-1157. DOI PMID
[6]	Mokkink LB, de Vet HCW, Prinsen CAC, et al. COSMIN Risk of Bias checklist for systematic reviews of Patient-Reported Outcome Measures[J]. Qual Life Res, 2018, 27(5):1171-1179. DOI PMID
[7]	Alhazzani W, Guyatt G. An overview of the GRADE approach and a peek at the future[J]. Med J Aust, 2018, 209(7):291-292. PMID
[8]	崔璀, 郑显兰, 陈文劲, 等. 癫痫青少年至成人过渡期准备评估问卷的汉化和信效度检验[J]. 中华护理杂志, 2023, 58(8):1017-1024. DOI URL
	Cui C, Zheng XL, Chen WJ, et al. Cross-cultural adaptation,reliability and validity of the Chinese version of the Transition Readiness Assessment Questionnaire for Adolescents with Epilepsy[J]. Chin J Nurs, 2023, 58(8):1017-1024.
[9]	Spiegel L, Tucker L, Duffy KW, et al. Development and valida-tion of the RACER(Readiness for Adult Care in Rheuma-tology) transition instrument in youth with juvenile idiopathic arthritis[J]. Pediatr Rheumatol Online J, 2021, 19(1):83. DOI PMID
[10]	Clark SJ, Beimer NJ, Gebremariam A, et al. Validation of Epi-TRAQ,a transition readiness assessment tool for adolescents and young adults with epilepsy[J]. Epilepsia Open, 2020, 5(3):487-495.
[11]	Pierce J, Hossain J, Gannon A. Validation of the Healthcare Transition Outcomes Inventory for young adults with type 1 diabetes[J]. J Pediatr Psychol, 2020, 45(7):767-779. DOI PMID
[12]	Pierce J, Aroian K, Schifano E, et al. Development and content validation of the Healthcare Transition Outcomes Inventory for young adults with type 1 diabetes[J]. J Patient Rep Out-comes, 2019, 3(1):71.
[13]	Schwartz LA, Hamilton JL, Brumley LD, et al. Development and content validation of the Transition Readiness Inventory item pool for adolescent and young adult survivors of childhood cancer[J]. J Pediatr Psychol, 2017, 42(9):983-994. DOI PMID
[14]	Marchak JG, Reed-Knight B, Amaral S, et al. Providers’ assess-ment of transition readiness among adolescent and young adult kidney transplant recipients[J]. Pediatr Transplant, 2015, 19(8):849-857.
[15]	Gilleland J, Amaral S, Mee L, et al. Getting ready to leave:transition readiness in adolescent kidney transplant recipients[J]. J Pediatr Psychol, 2012, 37(1):85-96. DOI PMID
[16]	Cleverley K, Davies J, Allemang B, et al. Validation of the Tran-sition Readiness Assessment Questionnaire(TRAQ) 5.0 for use among youth in mental health services[J]. Child Care Health Dev, 2023, 49(2):248-257.
[17]	Huang YZ, Wang HP, Diaz-Gonzalez de Ferris M, et al. Trans-lation and validation of the STARx questionnaire in tran-sitioning Chinese adolescents and young adults with chronic health conditions[J]. J Pediatr Nurs, 2023,71:111-119.
[18]	黄静, 王佳, 梁亚红, 等. 青少年过渡期准备自评量表的编制及信效度检验[J]. 护理学杂志, 2021, 36(17):36-39.
	Huang J, Wang J, Liang YH, et al. Development and validation of Self-assessment Scale of Transition Readiness for Adole-scents[J]. J Nurs Sci, 2021, 36(17):36-39.
[19]	Chapados P, Aramideh J, Lamore K, et al. Getting ready for transition to adult care:tool validation and multi-informant strategy using the Transition Readiness Assessment Question-naire in pediatrics[J]. Child Care Health Dev, 2021, 47(5):645-653.
[20]	Huang HY, Wang YW, Mao XR, et al. Translation and valida-tion of TRANSITION-Q for Chinese pediatric cancer survi-vors[J]. J Pediatr Nurs, 2021,61:130-135.
[21]	Francisco FD, Francisca LL, Romina VC. Assessment of know-ledge and autonomy for the transition from adolescent toward adult care[J]. Rev Chil Pediatr, 2020, 91(5):722-731. DOI PMID
[22]	Mellerio H, Jacquin P, Trelles N, et al. Validation of the “Good2Go”:the first French-language transition readiness questionnaire[J]. Eur J Pediatr, 2020, 179(1):61-71. DOI PMID
[23]	Sato Y, Ochiai R, Ishizaki Y, et al. Validation of the Japanese Transition Readiness Assessment Questionnaire[J]. Pediatr Int, 2020, 62(2):221-228. DOI PMID
[24]	Anelli CG, Len CA, Terreri MTRA, et al. Translation and vali-dation of the Transition Readiness Assessment Questionnaire (TRAQ)[J]. J Pediatr, 2019, 95(2):180-187.
[25]	Nazareth M, Hart L, Ferris M, et al. A parental report of youth transition readiness:the parent STARx questionnaire (STARx-P) and re-evaluation of the STARx child report[J]. J Pediatr Nurs, 2018,38:122-126.
[26]	Kızıler E, Yıldız D, Eren Fidancı B. Validation of Transition Readiness Assessment Questionaire in Turkish adolescents with diabetes[J]. Balkan Med J, 2018, 35(1):93-100. DOI PMID
[27]	González F, Roizen M, Rodríguez Celin ML, et al. Validation of the Argentine Spanish version of Transition Readiness Assessment Questionnaire for adolescents with chronic condi-tions[J]. Arch Argent Pediatr, 2017, 115(1):18-27.
[28]	De Cunto CL, Eymann A, Britos ML, et al. Cross-cultural ada-ptation of the Transition Readiness Assessment Questionnaire to Argentinian Spanish[J]. Arch Argent Pediatr, 2017, 115(2):181-187.
[29]	Sawicki GS, Garvey KC, Toomey SL, et al. Development and validation of the Adolescent Assessment of Preparation for Transition:a novel patient experience measure[J]. J Adolesc Health, 2015, 57(3):282-287.
[30]	Cantú-Quintanilla G, Ferris M, Otero A, et al. Validation of the UNC TRxANSITION Scale^TM Version 3 among Mexican ado-lescents with chronic kidney disease[J]. J Pediatr Nurs, 2015, 30(5):e71-e81.
[31]	Moynihan M, Saewyc E, Whitehouse S, et al. Assessing readi-ness for transition from paediatric to adult health care:revi-sion and psychometric evaluation of the Am I ON TRAC for Adult Care questionnaire[J]. J Adv Nurs, 2015, 71(6):1324-1335. DOI PMID
[32]	Ferris M, Cohen S, Haberman C, et al. Self-management and transition readiness assessment:development,reliability,and factor structure of the STARx questionnaire[J]. J Pediatr Nurs, 2015, 30(5):691-699. DOI PMID
[33]	Klassen AF, Grant C, Barr R, et al. Development and valida-tion of a generic scale for use in transition programmes to measure self-management skills in adolescents with chronic health conditions:the TRANSITION-Q[J]. Child Care Health Dev, 2015, 41(4):547-558.
[34]	Wood DL, Sawicki GS, Miller MD, et al. The Transition Rea-diness Assessment Questionnaire(TRAQ):its factor structure,reliability,and validity[J]. Acad Pediatr, 2014, 14(4):415-422.
[35]	Ferris ME, Harward DH, Bickford K, et al. A clinical tool to measure the components of health-care transition from pediatric care to adult care:the UNC TRxANSITION scale[J]. Ren Fail, 2012, 34(6):744-753. DOI PMID