Urban Native Youth Association, Vancouver, British Columbia, Canada.
Health Research Institute, University of Northern British Columbia, Prince George, British Columbia, Canada.
Compr Child Adolesc Nurs. 2023 Sep;46(3):201-222. doi: 10.1080/24694193.2020.1733707. Epub 2020 Mar 19.
The transition to adulthood is a critical time for everyone to build independence, experience new things, and become self-sufficient. With medical advances, individuals with complex chronic conditions are surviving into adulthood. As such they withstand additional challenges during this stage of their life including; facing a discontinuity of care, loss of prior health-care networks and champions, and a shift toward increased responsibility and self-management of their conditions. Often this shift results in the need for primary care providers to act as care managers, coordinating care and supporting the young adult as they navigate adulthood. In exploring the role of primary care providers with this population we reviewed the literature to identify what strategies primary care providers can use to enhance the transition process for young adults ages 15 to 25 years with complex chronic conditions exiting pediatric services. An integrative literature review approach was used to systematically search the contemporary literature. Applying inclusion criteria and quality assessment of relevant research and gray literature we identified 12 studies that warranted detailed review and analysis. Analysis of the studies highlighted four key themes: relationships, fear and anxiety, preparedness, and communication and collaboration. It was evident that health-care transition for young adults with complex chronic conditions was complicated by their psychosocial development and extensive health and service needs. Health-care transition is a team effort influenced by local contexts, resources, and relational practices. Both groups of primary care providers and young adults must be prepared prior to transition if they are to become immersed and engaged in this work. The population of young adults with complex chronic conditions exiting pediatric care will continue to grow as access to care delivery and medical technology continue to expand. While health-care transition for this population is complicated by extensive needs and psychosocial development, primary care providers can act as key supports in employing strategies to enhance the transition process for these young adults.
从儿童期到成年期的转变是每个人建立独立、体验新事物和变得自给自足的关键时期。随着医学的进步，患有复杂慢性疾病的个体能够存活到成年期。因此，他们在人生的这个阶段会面临更多的挑战，包括面临医疗服务的不连续性、失去先前的医疗保健网络和拥护者，以及转向更多地承担责任和自我管理自己的疾病。通常，这种转变导致初级保健提供者需要充当医疗保健管理者，协调护理，并在年轻人成年期时为其提供支持。在探讨初级保健提供者在这一人群中的作用时，我们回顾了文献，以确定初级保健提供者可以使用哪些策略来增强 15 至 25 岁患有复杂慢性疾病的年轻人从儿科服务过渡到成年期的过程。我们采用综合文献综述方法系统地搜索了当代文献。应用纳入标准和对相关研究和灰色文献的质量评估，我们确定了 12 项值得详细审查和分析的研究。对这些研究的分析突出了四个关键主题：关系、恐惧和焦虑、准备情况以及沟通和协作。显然，患有复杂慢性疾病的年轻人的医疗保健过渡受到其心理社会发展和广泛的健康和服务需求的影响。医疗保健过渡是一项团队努力，受到当地环境、资源和关系实践的影响。如果要让初级保健提供者和年轻人在过渡前做好准备并积极参与这项工作，他们都必须做好准备。随着医疗保健服务的提供和医疗技术的不断扩展，离开儿科护理的患有复杂慢性疾病的年轻人的数量将继续增加。尽管这一人群的医疗保健过渡因广泛的需求和心理社会发展而变得复杂，但初级保健提供者可以作为关键支持，采取策略来增强这些年轻人的过渡过程。
