Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
Queensland Paediatric Cardiac Service, Queensland Children's Hospital, Brisbane, QLD, Australia.
Dev Med Child Neurol. 2024 Feb;66(2):161-175. doi: 10.1111/dmcn.15698. Epub 2023 Jul 8.
To identify and map evidence describing components of neurodevelopmental follow-up care for children with congenital heart disease (CHD).
This was a scoping review of studies reporting components of neurodevelopmental follow-up programmes/pathways for children with CHD. Eligible publications were identified through database searches, citation tracking, and expert recommendations. Two independent reviewers screened studies and extracted data. An evidence matrix was developed to visualize common characteristics of care pathways. Qualitative content analysis identified implementation barriers and enablers.
The review included 33 studies. Twenty-one described individual care pathways across the USA (n = 14), Canada (n = 4), Australia (n = 2), and France (n = 1). The remainder reported surveys of clinical practice across multiple geographical regions. While heterogeneity in care existed across studies, common attributes included enrolment of children at high-risk of neurodevelopmental delay; centralized clinics in children's hospitals; referral before discharge; periodic follow-up at fixed ages; standardized developmental assessment; and involvement of multidisciplinary teams. Implementation barriers included service cost/resourcing, patient burden, and lack of knowledge/awareness. Multi-level stakeholder engagement and integration with other services were key drivers of success.
Defining components of effective neurodevelopmental follow-up programmes and care pathways, along with enhancing and expanding guideline-based care across regions and into new contexts, should continue to be priorities.
Twenty-two different neurodevelopmental follow-up care pathways/programmes were published, originating from four countries. Twelve additional publications described broad practices for neurodevelopmental follow-up across regions Common attributes across eligibility, service structure, assessment processes, and care providers were noted. Studies reported programme acceptability, uptake, cost, and effectiveness. Implementation barriers included service cost/resourcing, patient burden, and lack of knowledge/awareness.
确定并绘制描述先天性心脏病(CHD)儿童神经发育随访护理组成部分的证据。
这是对报告 CHD 儿童神经发育随访计划/途径组成部分的研究进行的范围审查。通过数据库搜索、引文追踪和专家推荐确定符合条件的出版物。两名独立审查员筛选研究并提取数据。开发了一个证据矩阵来可视化护理途径的共同特征。定性内容分析确定了实施障碍和促进因素。
该综述包括 33 项研究。21 项描述了美国(n=14)、加拿大(n=4)、澳大利亚(n=2)和法国(n=1)的个别护理途径。其余报告了跨越多个地理区域的临床实践调查。尽管研究之间的护理存在异质性,但共同特征包括招募有神经发育迟缓高风险的儿童;儿童医院的集中诊所;出院前转诊;定期在固定年龄进行发育评估;以及多学科团队的参与。实施障碍包括服务成本/资源、患者负担和缺乏知识/意识。多层面利益相关者的参与和与其他服务的整合是成功的关键驱动因素。
确定有效的神经发育随访计划和护理途径的组成部分,以及在区域内和新环境中加强和扩大基于指南的护理,应继续作为优先事项。
来自四个国家的 22 种不同的神经发育随访护理途径/计划被发表。另外 12 项出版物描述了跨地区神经发育随访的广泛实践。符合条件、服务结构、评估过程和护理提供者的共同属性。研究报告了方案的可接受性、采用率、成本和效果。实施障碍包括服务成本/资源、患者负担和缺乏知识/意识。