School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland; University College Dublin Centre for Interdisciplinary Research, Education & Innovation in Health Systems (IRIS Centre), Ireland.
School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland; University College Dublin Centre for Interdisciplinary Research, Education & Innovation in Health Systems (IRIS Centre), Ireland.
J Pediatr Nurs. 2024 Sep-Oct;78:e346-e363. doi: 10.1016/j.pedn.2024.07.026. Epub 2024 Aug 16.
Healthcare transition can be challenging for young people and families living with chronic kidney conditions, including those with rare renal disorders who often have multi-systemic conditions, those who have undergone kidney transplantation, and those who face intense treatments like dialysis. Comprehensive, holistic healthcare transition interventions are required, encompassing physical, psychosocial, sexual, educational and vocational support.
This manuscript presents a systematic scoping review synthesising the healthcare transition interventions to support youth and families within nephrology services.
This review followed Arksey and O'Malley's five-stage framework, updated by Levac, Colquhoun and O'Brien and the Joanna Briggs Institute. Six databases were systematically searched: CINAHL Plus with Full Text, Embase, PsycINFO, Web of Science, PubMed, and the Applied Social Sciences Index and Abstracts (ASSIA), locating 12,662 records. Following a systematic screening process, 28 articles met the inclusion criteria. Results were analysed systematically and presented using the PAGER framework developed by Bradbury-Jones et al. (2022).
Various interventions were sourced. Three broad patterns emerged: 1. Contextual Factors, e.g. cultural differences between paediatric and adult services; 2. Major Intervention Components, e.g. parental/familial/peer-to-peer support, and 3. Personal factors, e.g., self-management ability.
Few interventions are available to support youth with rare renal disorders, specifically. Future research must be directed at this cohort. Healthcare transition timing remains hotly contested, with additional guidance required to support decision-making. Finally, limited interventions have been evaluated for practice.
This review has provided various considerations/recommendations that should be taken into account when designing, implementing or evaluating future healthcare transition supports.
医疗保健的转变对于患有慢性肾脏疾病的年轻人和家庭来说可能具有挑战性，包括那些患有罕见肾脏疾病的人，他们通常有多种系统疾病，那些已经接受过肾移植的人，以及那些面临透析等强化治疗的人。需要综合、全面的医疗保健转变干预措施，包括身体、心理社会、性、教育和职业支持。
本文介绍了一项系统的范围综述，综合了肾病科服务中支持青年和家庭的医疗保健转变干预措施。
本研究遵循 Arksey 和 O'Malley 的五阶段框架，并更新了 Levac、Colquhoun 和 O'Brien 以及 Joanna Briggs 研究所的框架。系统地在六个数据库中进行了搜索：CINAHL Plus with Full Text、Embase、PsycINFO、Web of Science、PubMed 和 Applied Social Sciences Index and Abstracts (ASSIA)，共定位到 12662 条记录。经过系统的筛选过程，有 28 篇文章符合纳入标准。结果使用 Bradbury-Jones 等人（2022 年）开发的 PAGER 框架进行系统分析和呈现。
发现了各种干预措施。出现了三种广泛的模式：1. 背景因素，例如儿科和成人服务之间的文化差异；2. 主要干预组成部分，例如父母/家庭/同伴对同伴的支持；3. 个人因素，例如自我管理能力。
针对患有罕见肾脏疾病的年轻人，目前几乎没有专门的干预措施。未来的研究必须针对这一群体。医疗保健转变的时间仍然存在争议，需要额外的指导来支持决策。最后，有限的干预措施已经针对实践进行了评估。
本综述提供了各种考虑因素/建议，在设计、实施或评估未来的医疗保健转变支持措施时应考虑这些因素/建议。
