Wakimizu Rie, Sasaki Keita, Yoshimoto Mitsuki, Miyazaki Akari, Saito Yumiko
Department of Child Health Care Nursing, Division of Health Innovation and Nursing, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Master Program in Nursing Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
Front Pediatr. 2022 Jun 14;10:919865. doi: 10.3389/fped.2022.919865. eCollection 2022.
Owing to improved prognosis, the number of adult patients with childhood-onset chronic disease (APCCD) has increased. In this systematic review, we evaluated a multidisciplinary approach toward APCCD, focusing on promoting pediatric to adult healthcare transition interventions and their effects.
We reviewed literature comparing the effects of pediatric to adult healthcare transition interventions in children and adolescents with childhood-onset chronic disease, using PubMed, MEDLINE, and CINAHL, from 2010 to 2021 (keywords: "transition," "children," "intervention," "healthcare," etc.). The inclusion criteria were as follows: (i) original studies, (ii) studies on pediatric to adult healthcare transition interventions in children with chronic disease, (iii) patients including "adolescents" aged 12 and older receiving intervention, and (iv) studies that included the four elements of the PICO model: Patient/ Problem, Intervention, Comparison and Outcome model.
After evaluating 678 studies, 16 were selected, comprising topics such as "individual education programs" ( = 6), "group meetings" ( = 6), "active learning using information and communications technology" ( = 2), and "transition clinics" ( = 2). The effects obtained varied, depending on the contents and methods of the intervention. Additionally, there was no evidence of adverse outcomes from these interventions.
Pediatric to adult healthcare transition interventions provide systematic support for the transition, patient independence, and social participation; thus, they should be adopted based on their expected effects.
由于预后改善，患有儿童期起病的慢性病的成年患者（APCCD）数量有所增加。在本系统评价中，我们评估了针对APCCD的多学科方法，重点关注促进儿科到成人医疗保健过渡干预措施及其效果。
我们使用PubMed、MEDLINE和CINAHL检索了2010年至2021年期间比较儿科到成人医疗保健过渡干预措施对患有儿童期起病的慢性病的儿童和青少年影响的文献（关键词：“过渡”、“儿童”、“干预”、“医疗保健”等）。纳入标准如下：（i）原始研究；（ii）关于患有慢性病的儿童从儿科到成人医疗保健过渡干预措施的研究；（iii）患者包括12岁及以上接受干预的“青少年”；（iv）包括PICO模型四个要素的研究：患者/问题、干预措施、对照和结果模型。
在评估了678项研究后，选择了16项，包括“个体教育计划”（=6）、“小组会议”（=6）、“使用信息和通信技术的主动学习”（=2）和“过渡诊所”（=2）等主题。根据干预措施的内容和方法，获得的效果各不相同。此外，没有证据表明这些干预措施会产生不良后果。
儿科到成人医疗保健过渡干预措施为过渡、患者独立和社会参与提供了系统支持；因此，应根据其预期效果采用这些措施。
