Evaluating a Transition Workbook for Childhood Cancer Survivors: a Pilot Study

Features of Studies on Transition Interventions for Childhood Cancer Survivors: A Scoping Review

PURPOSE

in this scoping review, previously reported data were described and synthesized to document transition interventions in CCSs, and the features of intervention components of the current transition studies for CCSs were summarized.

METHODS

A literature search was conducted in PubMed, Web of Science, EMBASE, PsycINFO, CINAHL, Ovid, and the Cochrane Library following the PRISMA-ScR statement. All original studies (n = 9) investigating transition interventions in CCSs were included.

RESULTS

The current studies identified essential elements for transition programs, such as delivering knowledge, developing skills for coordination of care, and addressing psychosocial needs. However, the current transition interventions were generally in their infancy, and major deficits were found, including poorly reported intervention components and procedures, a limited number of relevant validated outcomes, and a failure to incorporate conceptual frameworks and international consensus statements.

CONCLUSIONS

This scoping review mapped current evidence of transition interventions for CCSs and highlighted the paucity of data in this area. More high-quality and well-reported randomized controlled trials are needed for the enrichment and standardization of future transition interventions.

Developing a theory-driven framework for a web-based intervention to improve transition in childhood cancer survivors: a protocol of realist synthesis

BACKGROUNDS AND PURPOSE

Childhood cancer survivors (CCSs) who transition through adolescence and enter young adulthood may suffer psychological, cognitive, social, fertility, and sexual issues and concerns. There is an urgent need for comprehensive intervention strategies to improve the transition of CCSs. Web-based technologies are gaining momentum as a new mechanism to provide healthcare and education for adolescents. However, previous frameworks have been limited in their effectiveness in explaining web-based interventions.This realist synthesis aims to synthesise current evidence on transition of CCSs to develop a framework for web-based interventions. The framework can foster understanding of the integrity of web-based intervention implementation chain, examine which mechanistic factors will be triggered by web-based interventions, note and examine the flows, blockages and points of contention in the implementation, to refine web-based interventions.

METHOD AND ANALYSIS

A realist synthesis that adheres to the Realist and Meta-narrative Evidence Syntheses-Evolving Standard will be used. Studies will be identified through PubMed, Web of Science, EMBASE, PsycINFO, CINAHL, Ovid and Cochrane Library from the period of January 2005 to May 2023. We will also search the reference lists provided in relevant studies and reviews. Articles will be screened based on two principles: (1) Relevance: does the research address the initial programme theory? (2) Rigour: whether a particular inference drawn by the original researcher has sufficient weight to make a methodologically credible contribution to the test of the initial programme theory. No restrictions regarding the design or language of publication will be considered.

ETHICS AND DISSEMINATION

As a review, ethical approval is not required. The results from this study will be presented at international conferences and disseminated through peer-reviewed publications. Patients and the public will be involved in the dissemination plans.

Young adults with eating disorders perspectives on educational resources to support the transition into adult medicine: a thematic analysis

Background

Eating disorders (EDs) commonly develop in adolescence and can be a chronic condition. Once patients reach the age when it is no longer permitted or appropriate for them to be seen in a children’s healthcare setting, they will need to transition into adult-focused care. This transition period can be challenging, with increased risks of negative health outcomes and disruptions in care. Appropriate educational resources could be an effective support for patients during this transition. Our objectives were to engage patients about the value of developing educational supports and determine how these supports should be structured to be most useful to young adults with EDs.

Methods

Patients who had transitioned out of a hospital-based ED program between 2017 and 2020 were invited to participate in a semi-structured interview. Data were analyzed using thematic analysis and qualitative description.

Results

Six young adults (5 females and 1 male) with EDs were interviewed. All participants thought it would be helpful to have an educational resource. Three main themes and seven subthemes were identified. Themes identified related to the unique challenges of transition for ED patients given the age of onset and cycle of symptoms; issues in adult care related to comorbidities and new level of autonomy; and the value of educational resources as both a connection tool and a benchmark. Participants also thought it would be useful to include in any educational resource a summary of their previous treatments, information regarding the transition process, a list of main healthcare providers they saw for their ED, a description of the differences and expectations of the adult system, a list of their follow up appointments, and a list of community and emergency mental health resources.

Conclusions

Participants said that educational supports can play a useful role for young adults with EDs during their transition into adult care. They also provided valuable insights into the desired contents of such supports and expanded on the roles that educational resources could serve for ED patients.

Most adolescents who have an eating disorder will reach an age when it is no longer appropriate for them to receive care in a children’s health program. They will then need to transition to an adult-focused program. This transition period can be challenging, with increased risks of negative health outcomes and disruptions in care. One approach for better supporting patients during transition is through the development of appropriate educational resources. Before developing these resources, it is important to hear from patients about how they should be structured to be as useful as possible. We interviewed six patients who had recently transitioned out of a pediatric eating disorder program about the value of an educational transition resource and what should be included in it. Patients identified several unique transition issues for young adults with eating disorders. We identified valuable insights and seven key themes from these interviews. While all patients recognized the value of educational resources, rather than being just a static source of information, they envisioned a resource that could also be a dynamic record of their previous care and a tool for engaging with their new adult-focused health care providers.