Transition from children’s to adult services for young adults with life-limiting conditions: A realist review of the literature

Abstract

Early planning, collaboration between children's and adult service providers, and a focus on increasing the young adults' confidence in decision-making and engaging with adult services, are vital to a successful transition. Interventions should be tailored to their context and focused not only on organisational procedures but on equipping young adults, parents/carers and staff to engage with each other effectively.

A cross-sectional survey of services for young adults with life-limiting conditions making the transition from children’s to adult services in Ireland

“…Thematic analysis involves an iterative process which required going back and forth to the data [30] using an inductive process. Of particular interest were data related to the six factors associated with a successful transition to adult services, identified in the realist literature review [26].…”

“…Forbes et al [25] suggest the professional transition model which relates to the availability of a supportive individual, such as a transition coordinator, is particularly suitable for young adults with a shorter life expectancy. Despite this, the survey results indicate that, with the exception of the hospices, most organisations in the statutory health and social care sector were unlikely to take this approach even though it is well supported in the wider literature [19,26].…”

“…This survey of transition services in Manchester and Greater London identified a number of approaches: the direct transition model which highlights the importance of communication and information sharing and interagency collaboration; the sequential transition model which focuses on constructing services as an extension to children's services or jointly between children's and adult services; the developmental transition model which focuses on active support for the young adults personal growth and development and finally, the professional transition model, which describes one key professional who takes responsibility for engaging key stakeholder groups to meet the young adults' needs in the transition process. We drew on this questionnaire and accompanying report to develop our own questionnaire, and supplemented the questions on the basis of a realist review of the recent literature [26]. This review identified six key factors associated with an effective transition.…”

“…However, more than half of the responding organisations reported having no transition policy (although most reported that they were in the process of developing them). This suggests a lack of preparation for key aspects of a successful transition such as effective communication between services and inter-agency working [26]. An early start to the transition process is recommended as a foundation for effective transition [19,26], with a consensus that this should commence when the young person is 13/14 years [12,16,34,35].…”

“…This suggests a lack of preparation for key aspects of a successful transition such as effective communication between services and inter-agency working [26]. An early start to the transition process is recommended as a foundation for effective transition [19,26], with a consensus that this should commence when the young person is 13/14 years [12,16,34,35]. In Northern Ireland, the usual age was 14 years, and in the Republic of Ireland, age 16 years.…”