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共同设计的医疗过渡干预措施,用于患有慢性病的青少年和年轻人:范围综述。

Co-designed healthcare transition interventions for adolescents and young adults with chronic conditions: a scoping review.

机构信息

School of Nursing and Midwifery, Western Sydney University, Penrith, Australia.

出版信息

Disabil Rehabil. 2022 Dec;44(24):7610-7631. doi: 10.1080/09638288.2021.1979667. Epub 2021 Oct 1.

Abstract

PURPOSE

To determine the scope of published literature on healthcare transition (HCT) interventions that have been co-designed with adolescents and young adults with chronic conditions, and to undertake feasibility assessments.

METHODS

Using Scopus, CINAHL, Medline-Ovid, Cochrane and PsycINFO databases, publications that included a HCT intervention to support paediatric to adult healthcare transition were included. Study location, design, population, description of the intervention, co-design methods, feasibility evidenced using Bowen and colleagues' framework, and outcome measures were extracted for review.

RESULTS

A total of 21 studies were included, relating to 17 co-designed HCT interventions that ranged across multiple medical specialties. There was no standard HCT intervention; characteristics, format and delivery mode varied. Only three studies reported a detailed description of the co-design method(s) used and none reported on the facilitators or barriers. Among the studies, five of Bowen and colleagues' eight dimensions of feasibility were measured.

CONCLUSIONS

Despite the co-design process being neither described or evaluated extensively, all co-designed HCT interventions included in this review were considered to be feasible. Nevertheless, HCT interventions varied in their format and delivery method making it difficult to compare between them. Furthermore, interventions were often condition-specific and not representative of the extensive range of chronic conditions.Implications for RehabilitationHealthcare transition interventions can improve adherence to care, health outcomes, ongoing rehabilitation, and quality of life of adolescents and young adults with chronic conditions.Healthcare transition interventions should maximise long-term functioning and prioritise rehabilitation aimed at enhancing independence and self-management skills, while reducing hospitalisations.The engagement of individuals with lived experience in the co-design of interventions has been strongly advocated as it brings unique knowledge and experience to the research process.Minimal attention has been given to the involvement of adolescents and young adults with chronic conditions in the development of healthcare transition interventions, however, healthcare transition interventions co-designed with adolescents and young adults with chronic conditions are both feasible and acceptable.

摘要

目的

确定与患有慢性病的青少年和年轻人共同设计的医疗保健过渡(HCT)干预措施的已发表文献的范围,并进行可行性评估。

方法

使用 Scopus、CINAHL、Medline-Ovid、Cochrane 和 PsycINFO 数据库,纳入了支持儿科到成人医疗保健过渡的 HCT 干预措施的出版物。提取研究地点、设计、人群、干预措施描述、共同设计方法、使用 Bowen 及其同事的框架评估的可行性证据以及结局指标进行综述。

结果

共纳入 21 项研究,涉及 17 项共同设计的 HCT 干预措施,涵盖多个医学专业。没有标准的 HCT 干预措施;特征、形式和交付模式各不相同。只有 3 项研究详细描述了使用的共同设计方法(s),没有研究报告促进因素或障碍。在这些研究中,Bowen 及其同事的可行性的八个维度中的五个得到了测量。

结论

尽管共同设计过程既没有得到广泛描述也没有进行广泛评估,但本综述中包含的所有共同设计的 HCT 干预措施都被认为是可行的。然而,HCT 干预措施在其形式和交付方式上存在差异,使得它们之间难以进行比较。此外,干预措施通常是针对特定疾病的,不能代表广泛的慢性疾病。

康复的意义

医疗保健过渡干预措施可以改善患有慢性病的青少年和年轻人的治疗依从性、健康结果、持续康复和生活质量。医疗保健过渡干预措施应最大限度地提高长期功能,并优先考虑旨在增强独立性和自我管理技能、同时减少住院治疗的康复。倡导让具有生活经验的个体参与干预措施的共同设计,因为这为研究过程带来了独特的知识和经验。尽管已经强烈倡导让患有慢性病的青少年和年轻人参与医疗保健过渡干预措施的制定,但在医疗保健过渡干预措施的制定中,很少关注患有慢性病的青少年和年轻人的参与,然而,与患有慢性病的青少年和年轻人共同设计的医疗保健过渡干预措施既可行又可接受。

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