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Transition from children’s to adult services for young adults with life-limiting conditions: A realist review of the literature

机译:有生命限制条件的年轻人从儿童过渡到成人服务:对文献的现实主义评论

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摘要

BackgroundImprovements in care and treatment have led to more young adults with life-limiting conditions living beyond childhood, which means they must make the transition from children’s to adult services. This has proved a challenging process for both young adults and service providers, with complex transition interventions interacting in unpredictable ways with local contexts.ObjectivesTo explain how intervention processes interact with contextual factors to help transition from children’s to adult services for young adults with life-limiting conditions.DesignSystematic realist review of the literature.Data sourcesLiterature was sourced from four electronic databases: Embase, MEDLINE, Science Direct and Cochrane Library from January 1995 to April 2016. This was supplemented with a search in Google Scholar and articles sourced from reference lists of included papers.Review methodsData were extracted using an adapted standardised data extraction tool which included identifying information related to interventions, mechanisms, contextual influences and outcomes. Two reviewers assessed the relevance of papers based on the inclusion criteria. Methodological rigor was assessed using the relevant Critical Appraisal Skills Programme tools.Results78 articles were included in the review. Six interventions were identified related to an effective transition to adult services. Contextual factors include the need for children’s service providers to collaborate with adult service providers to prepare an environment with knowledgeable staff and adequate resources. Mechanisms triggered by the interventions include a sense of empowerment and agency amongst all stakeholders.ConclusionsEarly planning, collaboration between children’s and adult service providers, and a focus on increasing the young adults’ confidence in decision-making and engaging with adult services, are vital to a successful transition. Interventions should be tailored to their context and focused not only on organisational procedures but on equipping young adults, parents/carers and staff to engage with each other effectively.
机译:背景技术护理和治疗的改善导致更多处于生命极限状态的年轻人生活在童年以后,这意味着他们必须从儿童服务过渡到成人服务。事实证明,这对年轻成人和服务提供者都是一个挑战性的过程,复杂的过渡干预以无法预测的方式与当地环境相互作用。目的说明干预过程如何与上下文因素相互作用,以帮助有生命限制的年轻成年人从儿童过渡到成人服务1995年1月至2016年4月,数据来自四个电子数据库:Embase,MEDLINE,Science Direct和Cochrane图书馆。在Google Scholar中的搜索和来自以下文献的参考列表中的文章得到了补充:审查方法数据是使用经过改编的标准化数据提取工具提取的,其中包括识别与干预措施,机制,情境影响和结果有关的信息。两位审稿人根据纳入标准评估了论文的相关性。使用相关的关键评估技能计划工具评估了方法的严谨性。结果78篇文章纳入了该评价。确定了与有效过渡到成人服务有关的六种干预措施。上下文因素包括,儿童服务提供商需要与成人服务提供商合作,以提供知识渊博的员工和充足资源的环境。干预措施触发的机制包括所有利益相关者之间的赋权和代理意识。结论早期计划,儿童和成人服务提供者之间的合作以及对提高年轻人对决策的信心和参与成人服务的关注对成功的过渡。干预措施应针对其情况进行调整,不仅应着重于组织程序,还应着眼于使年轻人,父母/照料者和工作人员有效地进行互动。

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