Transitioning adolescent and young adults with chronic disease and/or disabilities from paediatric to adult care services - an integrative review.
Huaqiong Zhou, Pamela Roberts, Satvinder Dhaliwal and 1 others
PMID 27145890WHAT IT FOUND
Adolescents and young adults with chronic disease or disability often feel anxious before moving to adult care, and post-transfer follow-up and medication use can be poor.
Structured preparation may help, but evidence on programme effectiveness is inconclusive.
Key findings
01Patients often felt anxious or unwilling before transition and worried about being accepted by adult services.
02Patients valued structured transition programmes, but anxiety levels did not change.
03Adult health care providers reported discomfort caring for young adults, and half were unwilling or not keen to accept them.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only English-language full-text studies were searched, so relevant non-English work may have been missed. Most included studies were nonexperimental self-report surveys, and many did not provide objective outcome data. Quality appraisal did not exclude any study, so weaker studies were included in the synthesis. Only two of the 15 qualitative studies reported their methodology and philosophy. The review covered heterogeneous approaches, many of which were not formally structured programmes, so effectiveness was hard to compare. Outcomes after transition were poorly tracked, and transition records were often incomplete.
The easy way to misread this
Do not conclude that structured transition programmes are proven to improve clinical outcomes. The review found only five studies that evaluated programmes, evidence on effectiveness was inconclusive, and patients' anxiety did not change.