Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Division of General Pediatrics, Cohen Children's Medical Center of Northwell Health, Queens, New York, USA.
Curr Opin Pediatr. 2018 Apr;30(2):303-310. doi: 10.1097/MOP.0000000000000608.
Transitioning adolescents and young adults with chronic conditions can be complex. Expert recommendations support a transition process that starts in early adolescence, provides continuous guidance and support and allows for care opportunities with patients and caregivers, with the patient alone and between paediatric and adult providers. As most of the guidance is focused on individual patients, providers and clinical programmes, much less is known about how health systems as a whole might support effective transitions of care.
Many intervention studies focus on the preparation necessary to successfully transition adolescents, young adults and their families to adult care. Although randomized controlled trials of transition interventions are few and standards of care not yet established, promising models are being developed and tested. This review will describe the development and implementation of emerging models of transitional care in primary and subspecialty care, paying special attention to evaluation outcomes that can inform model selection.
The emerging models described here highlight the importance of and guidance for invested clinicians and health systems to create effective methods for successful transition. Additional research using rigorous methodology is necessary.
患有慢性病的青少年和青年向成人过渡可能较为复杂。专家建议的过渡过程应始于青少年早期，提供持续的指导和支持，并为患者和照护者、患者本人以及儿科和成人提供者之间提供护理机会。由于大多数指导意见主要针对个体患者、提供者和临床项目，因此对于整个卫生系统如何支持有效的护理过渡知之甚少。
许多干预研究都侧重于为成功过渡到成人护理做准备，包括青少年、青年及其家庭。虽然过渡干预的随机对照试验较少，且护理标准尚未建立，但正在开发和测试有前途的模式。这篇综述将描述初级保健和专科保健中新兴过渡护理模式的制定和实施情况，特别关注可用于指导模式选择的评估结果。
这里描述的新兴模式强调了投入的临床医生和卫生系统的重要性和指导作用，以创建有效的成功过渡方法。需要使用严格的方法学进行更多的研究。
