Britton Authors Jordyn, Szymanski Lindsey, John Anitha
Department of Cardiology, Children's National Hospital, Washington, DC, USA.
Department of Pediatrics, George Washington University, Washington, DC, USA.
Pediatr Cardiol. 2025 Jun 25. doi: 10.1007/s00246-025-03928-z.
The growing adult CHD population has created a demand for formalized transition programs from pediatric to adult cardiac care. Despite global implementation, these programs vary widely in structure, and there is limited understanding of which elements best improve clinical outcomes and quality of life. This scoping review of the literature on healthcare transition programs for children and adolescents with CHD examined various program models, identified common key concepts, and highlighted gaps in the field, providing future directions for research and program development. A comprehensive search of PUBMED/Medline, Scopus, CINAHL, and Cochrane Library (2017-2023) identified English-language original research on CHD transition programs reporting qualitative or quantitative outcomes. Outcomes were grouped into themes: medical knowledge, self-management, and successful transfer. Ten studies met the inclusion criteria. All seven studies reporting medical knowledge outcomes found an increase in patients' medical knowledge following program completion, though methods of measurement varied. Four studies reported successful transfer outcomes, while five demonstrated improvements in self-management skills. Several studies also included patient reported outcomes. While various healthcare transition models exist, each with distinct strengths and weaknesses, it is important to customize the program to the needs of the local CHD patient population and the institution providing care. Advancing care for this group requires increased resources, improved reimbursement models, stronger infrastructure, and comprehensive education and training to encourage institutions to develop programs that meet patient needs.
不断增长的成年冠心病患者群体催生了对从儿科心脏护理到成人心脏护理的规范化过渡项目的需求。尽管这些项目在全球范围内得到了实施,但其结构差异很大,对于哪些要素能最有效地改善临床结果和生活质量的了解有限。这项针对患有冠心病的儿童和青少年医疗保健过渡项目的文献综述,考察了各种项目模式,确定了共同的关键概念,并突出了该领域的差距,为未来的研究和项目开发提供了方向。对PUBMED/Medline、Scopus、CINAHL和Cochrane图书馆(2017 - 2023年)进行全面检索,确定了关于冠心病过渡项目的英文原创研究,这些研究报告了定性或定量结果。结果被归纳为几个主题:医学知识、自我管理和成功过渡。十项研究符合纳入标准。所有七项报告医学知识结果的研究都发现,项目完成后患者的医学知识有所增加,尽管测量方法各不相同。四项研究报告了成功过渡的结果,五项研究表明自我管理技能有所改善。几项研究还纳入了患者报告的结果。虽然存在各种医疗保健过渡模式,每种模式都有其独特的优缺点,但根据当地冠心病患者群体和提供护理的机构的需求定制项目很重要。改善这一群体的护理需要增加资源、改进报销模式、加强基础设施建设,以及进行全面的教育和培训,以鼓励各机构开发满足患者需求的项目。