Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
University of Toronto Libraries, and.
Pediatrics. 2020 Nov;146(5). doi: 10.1542/peds.2020-0187. Epub 2020 Oct 12.
Transition from the pediatric to the adult health care system is a complex process that should include medical, psychosocial, educational, recreational, and vocational considerations.
In this systematic review, we aim to synthesize the evidence on transitional care interventions (TCIs) to improve the quality of life (QoL) for adolescents and young adults with childhood-onset disabilities, including neurodevelopmental disorders.
Four electronic databases (Medline, Embase, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature) were searched.
In the included studies, researchers examined TCIs for adolescents and young adults (12-24 years of age) with childhood-onset disabilities. Studies were experimental, quasi-experimental, and observational studies published in the last 26 years.
Two reviewers independently completed study screening, data extraction, and risk-of-bias assessment.
Fifty-two studies were included. Five studies reported on QoL, but statistically significant improvements were noted in only 1 of these studies. Significant improvements were also found in secondary outcomes including disability-related knowledge and transitional readiness. TCIs targeted patients, families and/or caregivers, and health care providers and exhibited great heterogeneity in their characteristics and components.
Inconsistent reporting on interventions between studies hindered synthesis of the relationships between specific intervention characteristics and outcomes.
Although there is limited evidence on the impact of TCIs on the QoL for youth with childhood-onset disabilities, there is indication that they can be effective in improving patient and provider outcomes. The initiation of transition-focused care at an early age may contribute to improved long-term health outcomes in this population.
从儿科到成人保健系统的过渡是一个复杂的过程，应包括医疗、心理社会、教育、娱乐和职业方面的考虑。
在这项系统评价中，我们旨在综合过渡护理干预措施（TCIs）的证据，以提高患有儿童期起病残疾（包括神经发育障碍）的青少年和年轻成年人的生活质量（QoL）。
四个电子数据库（Medline、Embase、PsycINFO 和 Cumulative Index to Nursing and Allied Health Literature）进行了检索。
在纳入的研究中，研究人员研究了针对患有儿童期起病残疾的青少年和年轻成年人（12-24 岁）的 TCI。这些研究是在过去 26 年中发表的实验性、准实验性和观察性研究。
两名审查员独立完成了研究筛选、数据提取和偏倚风险评估。
共纳入 52 项研究。有 5 项研究报告了生活质量，但只有 1 项研究报告了统计学意义上的显著改善。在包括残疾相关知识和过渡准备在内的次要结局方面也发现了显著改善。TCIs 的目标是患者、家庭和/或照顾者以及医疗保健提供者，其特征和组成具有很大的异质性。
研究之间干预措施的报告不一致，阻碍了特定干预特征与结果之间关系的综合分析。
尽管关于 TCI 对儿童期起病残疾青年生活质量影响的证据有限，但有迹象表明它们可以有效改善患者和提供者的结局。在早期开始以过渡为重点的护理可能有助于改善该人群的长期健康结局。
