A complex transition: lessons learned as three young adults with complex care needs transition from an inpatient paediatric hospital to adult community residences

Lindsay, Sally; Hoffman, Amber

doi:10.1111/cch.12203

Cited by 15 publications

(15 citation statements)

References 20 publications

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“…Reasons for excluding the 6 eligible articles at the last stage include: aims do not align with meta-ethnography aim, context too specific, or inadequate number of youth/family participants. For example, we excluded a study exploring the transition of three young adults from an inpatient pediatric hospital to adult community residences [27], as there was not enough representation of youth/family perspectives and the context was also too specific to translate well into the other included studies (see Supplementary Material 3 for a list of excluded studies).…”

Section: Resultsmentioning

confidence: 99%

Experiences of youth with medical complexity and their families during the transition to adulthood: a meta-ethnography

Bird

Carter

et al. 2020

Journal of Transition Medicine

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Youth with medical complexity (YMC) are a small subset of youth who have a combination of severe functional limitations and extensive health service use. As these youth become adults, they are required to transition to adult health, education, and social services. The transition to adult services is especially difficult for YMC due to the sheer number of services that they access. Service disruptions can have profound impacts on YMC and their families, potentially leading to an unsuccessful transition to adulthood. This meta-ethnography aims to synthesize qualitative literature exploring how YMC and their families experience the transition to adulthood and transfer to adult services. An in-depth understanding of youth and family experiences can inform interventions and policies to optimize supports and services to address the needs of this population at risk for unsuccessful transition to adulthood. Using Noblit and Hare’s approach to meta-ethnography, a comprehensive search of Medline, CINAHL, Embase, PsycINFO, Social Sciences Index, and Sociological Abstracts databases, supplemented by hand searching, was conducted to identify relevant studies. Included studies focused on the transition to adulthood or transfer to adult services for YMC, contained a qualitative research component, and had direct quotes from youth or family participants. Studies were critically appraised, and data were analyzed using meta-ethnographic methods of reciprocal translation and line of argument synthesis. Conceptual data from ten studies were synthesized into six overarching constructs: (1) the nature and process of transition, (2) changing relationships, (3) goals and expectations, (4) actions related to transition, (5) making sense of transition, and (6) contextual factors impacting transition. A conceptual model was developed that explains that youth and families experience dynamic interactions between their goals, actions, and relationships, which are bounded and influenced by the nature, process, and context of transition. Despite the tremendous barriers faced during transition, YMC and their families often demonstrate incredible resilience, perseverance, and resourcefulness in the pursuit of their goals. Implications for how the conceptual model can inform practice, policy, and research are shared. These implications include the need to address emotional needs of youth and families, support families in realizing their visions for the future, promote collaboration among stakeholders, and develop policies to incentivize and support providers in implementing current transition guidelines.

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Section: Resultsmentioning

confidence: 99%

Experiences of youth with medical complexity and their families during the transition to adulthood: a meta-ethnography

Bird

Carter

et al. 2020

Journal of Transition Medicine

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“…Transition of pediatric patients is not a one-off procedure but is a systematic gradual process [2]. This process should be well planned and timely to ensure effective roll over of care and…”

Section: Resultsmentioning

confidence: 99%

Effects of Transition from Pediatrics to Adult Oriented Health Care of Patients with Chronic Disease: A Literature Review

Francis

2019

IJNC

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Search strategyInitially, relevant texts were identified by general internet searches using Google Scholar. Then a systematic keyword search on CINAHL, Medline, Cochrane database, Nursing Ovid and PubMed was conducted in August 2015 to access literature relevant to the chosen topic. Keywords and Boolean operators such as "transition to adult hospitals" or "transition of pediatric patients" and "effects of transition" or "patients with chronic diseases and transition" were used to identify relevant literature. The search was restricted to full text publications between 2000 and 2015 and those published only in English. Abstracts of relevant articles were read in order to define appropriateness for inclusion in this paper. The identified articles were read thoroughly and critically analyzed for an effective qualitative study on the chosen topic. ResultsTransition of pediatric patients is not a one-off procedure but is a systematic gradual process [2]. This process should be well planned and timely to ensure effective roll over of care and

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“…Some children have the potential of being increasingly technology dependent as their illness progresses, depending on their comorbidities [19][20][21][22][23][24][25]. This often emerged in the literature related to specific care transitions including from hospital to home [26][27][28][29][30][31][32][33] and moving from children's services to adult services [32,[34][35][36][37].…”

Section: Dependency Continuummentioning

confidence: 99%

A systematic concept analysis of ‘technology dependent’: challenging the terminology

et al. 2020

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There are an increasing number of children who are dependent on medical technology to sustain their lives. Although significant research on this issue is taking place, the terminology used is variable and the concept of technology dependence is ill-defined. A systematic concept analysis was conducted examining the attributes, antecedents, and consequences of the concept of technology dependent, as portrayed in the literature. We found that this concept refers to a wide range of clinical technology to support biological functioning across a dependency continuum, for a range of clinical conditions. It is commonly initiated within a complex biopsychosocial context and has wide ranging sequelae for the child and family, and health and social care delivery. Conclusion: The term technology dependent is increasingly redundant. It objectifies a heterogenous group of children who are assisted by a myriad of technology and who adapt to, and function with, this assistance in numerous ways.

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A complex transition: lessons learned as three young adults with complex care needs transition from an inpatient paediatric hospital to adult community residences

Abstract: There are several challenges to overcome in preparing long-term hospitalized young adults with complex care needs to transition to adult supportive housing; however, these challenges may be overcome with targeted supports in several key areas.

Cited by 15 publications

References 20 publications

Experiences of youth with medical complexity and their families during the transition to adulthood: a meta-ethnography

Experiences of youth with medical complexity and their families during the transition to adulthood: a meta-ethnography

Effects of Transition from Pediatrics to Adult Oriented Health Care of Patients with Chronic Disease: A Literature Review

A systematic concept analysis of ‘technology dependent’: challenging the terminology

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