Duncan Andrea, Luong Dorothy, Perrier Laure, Bayley Mark T, Andrew Gail, Arbour-Nicitopoulos Kelly, Chan Brian, Curran C J, Dimitropoulos Gina, Hartman Laura, Huang Lennox, Kastner Monika, Kingsnorth Shauna, McCormick Anna, Nelson Michelle, Nicholas David, Penner Melanie, Thompson Laura, Toulany Alene, Woo Amanda, Zee Joanne, Munce Sarah E P
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
Front Pediatr. 2021 Sep 13;9:682078. doi: 10.3389/fped.2021.682078. eCollection 2021.
Transitional care interventions have the potential to optimize continuity of care, improve health outcomes and enhance quality of life for adolescents and young adults living with chronic childhood-onset disabilities, including neurodevelopmental disorders, as they transition to adult health and social care services. The paucity of research in this area poses challenges in identifying and implementing interventions for research, evaluation and implementation. The purpose of this project was to advance this research agenda by identifying the transitional care interventions from the scientific literature and prioritize interventions for study. A modified-Delphi approach involving two rounds of online surveys followed by a face-to-face consensus meeting with knowledge users, researchers and clinician experts in transitional care (n = 19) was used. A subsequent virtual meeting concluded the formulation of next steps. Experts rated 16 categories of interventions, derived from a systematic review, on importance, impact, and feasibility. Seven of the 16 interventions categories received a mean score rating of ≥7 (out of 10) on all three rating categories. Participants then rank ordered the reduced list of seven interventions in order of priority and the top four ranked interventions advanced for further discussion at a consensus meeting. Using the Template for Intervention Description and Replication (TIDieR) checklist as a guide, the participants identified that a study of a was worthy of future evaluation. This study highlighted that transitional care interventions are complex and multifaceted. However, the presence of a peer to support system navigation, advocacy and individual and family education was considered the most ideal intervention addressing the current gap in care. Future research, which aims to engage patients and families in a co-design approach, is recommended to further develop this intervention.
过渡性护理干预措施有潜力优化护理的连续性,改善患有慢性儿童期疾病(包括神经发育障碍)的青少年和年轻人在向成人健康和社会护理服务过渡时的健康状况并提高其生活质量。该领域研究的匮乏给确定和实施用于研究、评估及实施的干预措施带来了挑战。本项目的目的是通过从科学文献中识别过渡性护理干预措施并对研究干预措施进行优先排序来推进这一研究议程。采用了一种改良的德尔菲法,包括两轮在线调查,随后与过渡性护理方面的知识使用者、研究人员和临床专家(n = 19)举行面对面的共识会议。随后的一次虚拟会议确定了下一步计划。专家们对从系统评价中得出的16类干预措施在重要性、影响和可行性方面进行了评分。16类干预措施中有7类在所有三个评分类别上的平均得分评级≥7(满分10分)。参与者随后对七项干预措施的精简清单按优先顺序进行了排序,排名前四的干预措施在共识会议上进行了进一步讨论。以干预描述和复制模板(TIDieR)清单为指导,参与者确定一项关于[此处原文缺失具体内容]的研究值得未来评估。这项研究强调过渡性护理干预措施是复杂且多方面的。然而,存在同伴支持系统导航、宣传以及个人和家庭教育被认为是解决当前护理差距的最理想干预措施。建议未来旨在让患者和家庭参与共同设计方法的研究进一步开发这种干预措施。