Ebel Florian, Greuter Ladina, Guzman Raphael, Soleman Jehuda
Department of Neurosurgery, University Hospital of Basel, 4031 Basel, Switzerland.
Department of Pediatric Neurosurgery, University Children's Hospital of Basel, 4056 Basel, Switzerland.
Children (Basel). 2022 Apr 2;9(4):501. doi: 10.3390/children9040501.
Due to advances in the treatment of pediatric brain tumors (PBT), an increasing number of patients are experiencing the transition from the pediatric to the adult health care system. This requires efficient transitional models.
We systematically reviewed the literature regarding PBT concerning different transitional models and aspects of the transitional period. For this purpose, PubMed, Medline, and Embase databases were searched systematically through January 2022.
We reviewed a total of 304 studies, of which 15 were ultimately included. We identified five transition models described within the literature, while the most frequently mentioned ones were the "adult caregiver model" (45.5%), "joint caregiver model" (45.5%), "continued caregiver model" (27.3%), and the "specialized clinic model" (27.3%). During the transition, the most frequent challenges mentioned by the patients were the lack of knowledge about the disease by the adult health care professionals (62.5%) and the difficulty of establishing a new relationship with the new physician, environment, or hospital (37.5%).
An efficient transitional model is mandatory for patients with PBT. Continuity in the treatment and care of the patient and their family is essential. For this purpose, in patients with PBT, the "continued caregiver model", and for NF1 and TSC patients, the "specialized clinic model" seems optimal to offer continuity of care. If such models are unavailable, efficient communication with patients, families, and specialists in a multidisciplinary network is even more critical.
由于小儿脑肿瘤(PBT)治疗方面的进展,越来越多的患者正经历从儿科医疗系统向成人医疗系统的过渡。这需要高效的过渡模式。
我们系统回顾了有关PBT不同过渡模式及过渡期各方面的文献。为此,系统检索了截至2022年1月的PubMed、Medline和Embase数据库。
我们共回顾了304项研究,最终纳入15项。我们在文献中确定了五种过渡模式,其中最常被提及的是“成人护理模式”(45.5%)、“联合护理模式”(45.5%)、“持续护理模式”(27.3%)和“专科诊所模式”(27.3%)。在过渡期间,患者提到的最常见挑战是成人医疗专业人员对疾病缺乏了解(62.5%)以及与新医生、新环境或新医院建立新关系困难(37.5%)。
对于PBT患者,高效的过渡模式是必不可少的。患者及其家庭治疗和护理的连续性至关重要。为此,对于PBT患者,“持续护理模式”,对于神经纤维瘤病1型(NF1)和结节性硬化症(TSC)患者,“专科诊所模式”似乎最有利于提供连续护理。如果没有此类模式,在多学科网络中与患者、家庭和专家进行有效沟通就更为关键。