Thanalingam Yattheesh, Langridge Fiona Catherine, Russell Jin, Johansen Anita, Howlett Rachel, Muir Colette
Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Department of Paediatrics, Child and Youth Health, The University of Auckland, Auckland, New Zealand.
J Paediatr Child Health. 2025 Jun;61(6):941-956. doi: 10.1111/jpc.70054. Epub 2025 Apr 10.
Transition from paediatric to adult healthcare is a challenging time for young adults with neurodevelopmental conditions (NDC). The fragmentation and deficits in health, social and disability systems, and the increasing numbers of people with NDC, mean a more guided transition focusing on health independence is needed. This study aimed to develop a holistic transition tool and identify areas for improvement in transition services based on the consensus of experts involved with the care of children with NDC in Aotearoa, New Zealand.
Utilising the Delphi method, two rounds (Round One: open-ended, Round Two: Likert scale) of online questionnaires involving 61 panellists (healthcare professionals, educators and caregivers) reviewed areas for improvement in transition services and ideas for a transition tool.
In Round One, Delphi participants identified seven themes related to transition services, including processes, resources, professionals, governance and culture; and 10 themes related to components of the tool, including communication, healthcare management, rights, activities, supports and community connectedness, whānau/family, culture, mental and spiritual health and sexual health. In Round Two, 94% of the ideas for transition services items reached consensus (26% with strong consensus [> 95%]). All the components of the transition tool reached consensus, and 62% of items reached strong consensus (> 95%).
This study provides direction on key domains related to transition services and a framework for a transition tool for young adults with NDC in Aotearoa, New Zealand. Its inclusion of domains related to culture, mental and spiritual health, rights for young adults, family involvement and community connectedness is a first step in developing a holistic approach to support a successful transition.
对于患有神经发育障碍（NDC）的年轻人而言，从儿科医疗向成人医疗的过渡是一个充满挑战的时期。健康、社会和残疾系统的碎片化及不足，以及患有NDC的人数不断增加，意味着需要一种更具指导性的、以健康独立为重点的过渡方式。本研究旨在开发一种全面的过渡工具，并基于新西兰奥特亚罗瓦参与NDC儿童护理的专家共识，确定过渡服务中需要改进的领域。
采用德尔菲法，通过两轮在线问卷（第一轮：开放式；第二轮：李克特量表），对61名小组成员（医疗保健专业人员、教育工作者和护理人员）进行调查，以审查过渡服务中需要改进的领域以及过渡工具的构想。
在第一轮中，德尔菲法参与者确定了与过渡服务相关的七个主题，包括流程、资源、专业人员、治理和文化；以及与工具组件相关的10个主题，包括沟通、医疗保健管理、权利、活动、支持和社区联系、毛利大家庭/家庭、文化、心理和精神健康以及性健康。在第二轮中，94%的过渡服务项目构想达成了共识（26%达成强烈共识[>95%]）。过渡工具的所有组件都达成了共识，62%的项目达成了强烈共识（>95%）。
本研究为新西兰奥特亚罗瓦患有NDC的年轻人提供了与过渡服务相关的关键领域的指导以及过渡工具的框架。其纳入与文化、心理和精神健康、年轻人权利、家庭参与和社区联系相关的领域，是朝着制定全面方法以支持成功过渡迈出的第一步。
