Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.
Int J Environ Res Public Health. 2021 Mar 28;18(7):3513. doi: 10.3390/ijerph18073513.
To improve outcomes in children and young adults (CYAs) with chronic conditions, it is important to promote self-care through education and support.
(1) to retrieve the literature describing theories or conceptual models of self-care in CYAs with chronic conditions and (2) to develop a comprehensive framework.
A systematic literature search was conducted on nine databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All peer-reviewed papers describing a theory or a conceptual model of self-care in CYAs (0-24 years) with chronic conditions were included.
Of 2674 records, 17 met the inclusion criteria. Six papers included a theory or a model of self-care, self-management, or a similar concept. Six papers developed or revised pre-existing models or theories, while five papers did not directly focus on a specific model or a theory. Patients were CYAs, mainly with type 1 diabetes mellitus and asthma. Some relevant findings about self-care in CYAs with neurocognitive impairment and in those living with cancer may have been missed.
By aggregating the key elements of the 13 self-care conceptual models identified in the review, we developed a new overarching model emphasizing the shift of self-care agency from family to patients as main actors of their self-management process. The model describes influencing factors, self-care behaviors, and outcomes; the more patients engaged in self-care behaviors, the more the outcomes were favorable.
为改善患有慢性疾病的儿童和青少年（CYAs）的结局，通过教育和支持促进自我护理非常重要。
（1）检索描述 CYAs 慢性疾病自我护理理论或概念模型的文献，（2）制定综合框架。
根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，在九个数据库中进行了系统文献检索。所有描述 CYAs（0-24 岁）慢性疾病自我护理理论或概念模型的同行评审论文均包括在内。
在 2674 条记录中，有 17 条符合纳入标准。六篇论文包含自我护理、自我管理或类似概念的理论或模型。六篇论文开发或修订了预先存在的模型或理论，而五篇论文并未直接关注特定的模型或理论。患者为 CYAs，主要患有 1 型糖尿病和哮喘。可能遗漏了一些关于患有神经认知障碍和癌症的 CYAs 的自我护理的相关发现。
通过汇总本综述中确定的 13 个自我护理概念模型的关键要素，我们开发了一个新的总体模型，强调自我护理机构从家庭向患者转移，作为他们自我管理过程的主要参与者。该模型描述了影响因素、自我护理行为和结果；患者自我护理行为越多，结果越有利。
