1
|
Champagne E, Chénard J, Simard C, Bonanno M, Bogossian A, Roberge V, Olivier-d'Avignon M, Ummel D, Fortin G, Bergeron F, Bonenfant F. Scoping Review on Transitions in the Context of Pediatric Palliative Care. J Palliat Med 2024; 27:1541-1554. [PMID: 39047058 DOI: 10.1089/jpm.2023.0673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
Background: Children with complex and chronic conditions receiving palliative care will likely experience many transitions during their life and their treatments. Transition periods for children with life-limiting conditions and their families can be bewildering and highly anxiety-inducing. However, clinical observations seem to point to a more heterogenous care offer, including a lack or discontinuity of services, at the expense of their quality of life. Objective: This paper aims to establish a portrait of the existing literature and identify research gaps on the multiple transitions experienced by this population. Design: A scoping review is provided, following a PRISMA protocol. MEDLINE, PubMed and CINAHL were consulted. The search strategy is based on three key concepts: (1) palliative care/complex condition, (2) child/adolescent, and (3) transition. Articles were screened with the help of Covidence. Results: A total of 72 articles are included for analysis. The aimed population is either identified by age group or by medical status. Respondents are most often parents rather than the children themselves. Transitions include: reaching adulthood, changes in care environment, changes in medical status, and school integration. Conclusion: The discussion notices a definitional murkiness about transitions and highlights the fact that the multifaceted and complex nature of transition over time is largely ignored. New research should involve a diversity of participants and include children's voices. Recommendations include clearer concept definitions, health care policies that adopt an ecosystemic approach, and professional training in the systemic family approach in palliative care.
Collapse
Affiliation(s)
- Elaine Champagne
- Chair of Religion, spirituality and health, Faculty of theology and religious sciences, Université Laval, Québec Canada
| | - Josée Chénard
- Social Work Department, Université du Québec en Outaouais, St-Jérôme Canada
| | - Chantale Simard
- Department of health sciences, Université du Québec à Chicoutimi, Canada
| | | | - Aline Bogossian
- School of Social Work, Université de Montréal, Montréal, Canada
| | - Véronique Roberge
- Department of health sciences, Université du Québec à Chicoutimi, Canada
| | | | - Deborah Ummel
- Faculty of Education, Université de Sherbrooke, Sherbrooke, Canada
| | | | | | | |
Collapse
|
2
|
Benini F, Brogelli L, Mercante A, Giacomelli L. Transition to Adulthood in Pediatric Palliative Care: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:860. [PMID: 39062309 PMCID: PMC11276494 DOI: 10.3390/children11070860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/08/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
Pediatric palliative care (PPC) is defined as "the active care of the child's body, quality of life, mind and spirit, also giving support to the family". PPC should be established once a diagnosis of life-limiting or life-threatening disease is reached and should continue as long as necessary. Therefore, pediatric palliative care (PPC) can continue for years, also given the improved care approaches for children with life-limiting or life-threatening diseases. Over time, the child may grow to become a young adult, and when this happens, the transition to adult healthcare services must be undertaken. This article discusses possible interventions, fostering an efficient transition from pediatric to adult palliative care. A narrative review presents issues, experiences, and existing programs. A "Perspectives" section presents opinions and proposals by the authors. The transition process is not limited to a change from pediatric to adult services. Rather, it includes the entire process of the development of the child and requires interdisciplinary management with proper planning and collaboration among professionals of pediatric and adult teams.
Collapse
Affiliation(s)
- Franca Benini
- Pediatric Palliative Care, Pain Service, Department of Women’s and Children’s Health, University of Padua, 35122 Padua, Italy;
| | | | - Anna Mercante
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
| | | |
Collapse
|
3
|
Tornivuori A, Kallio M, Culnane E, Pasanen M, Salanterä S, Sawyer S, Kosola S. Transition readiness and anxiety among adolescents with a chronic condition and their parents: A cross-sectional international study. J Adv Nurs 2024; 80:756-764. [PMID: 37691321 DOI: 10.1111/jan.15860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 08/14/2023] [Accepted: 08/30/2023] [Indexed: 09/12/2023]
Abstract
AIMS To evaluate associations of age, transition readiness and anxiety in adolescents with chronic conditions and to compare perceptions of adolescents and their parents regarding health self-management and transition readiness. DESIGN Cross-sectional international study, reported following STROBE guidelines. METHODS Adolescents and young adults (N = 512, mean age 17.7) with a chronic medical condition and their parents (N = 322) from Finland and Australia. Data were collected through surveys (between September 2017 and December 2020). Adolescents reported the duration of their condition. Age at survey was defined by the response date of the questionnaires. Validated questionnaires were used to measure transition readiness (Am I ON TRAC? for Adult Care) and anxiety related to transition of care (State-Trait Anxiety Inventory short form). Perceptions of health self-management and transition readiness were compared in adolescent/parent dyads. Associations were explored using Spearman's correlation. RESULTS Duration of condition and age at survey correlated weakly with transition readiness knowledge and behaviour. Higher transition readiness knowledge scores correlated with higher behaviour scores. Higher transition readiness behaviour scores were associated with lower levels of anxiety. Adolescents were less anxious than their parents and adolescents and parents mostly agreed about health self-management and transition readiness. CONCLUSION Transition readiness should be determined by an assessment of knowledge, self-management and psychosocial skills instead of age alone. Further research should address how well transition readiness predicts positive health outcomes after the transfer of care. IMPLICATIONS FOR PATIENT CARE Transition readiness and self-management skills should be formally assessed because positive feedback may decrease the anxiety of both adolescents and their parents regarding the transfer of care. REPORTING METHOD We have adhered to the STROBE statement, using STROBE checklist for cross-sectional studies. PATIENT OR PUBLIC INVOLVEMENT STATEMENT No patient or public involvement. TRIAL AND PROTOCOL REGISTRATION ClinicalTrials.org NCT04631965.
Collapse
Affiliation(s)
- Anna Tornivuori
- Nursing Science, University of Turku, Turku, Finland
- Nursing Research Center NRC, Helsinki University Hospital, Helsinki, Finland
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
| | - Mira Kallio
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Evelyn Culnane
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Miko Pasanen
- Nursing Science, University of Turku, Turku, Finland
| | - Sanna Salanterä
- Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | - Susan Sawyer
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Royal Children's Hospital, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Adolescent Medicine, The Royal Children's Hospital Melbourne, Melbourne, Australia
| | - Silja Kosola
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| |
Collapse
|
4
|
Feather J, Kaehne A, Kiernan J. Evaluating the implementation of a person-centred transition programme for adolescents and young adults with long-term conditions: the role of context and organisational behaviour. J Health Organ Manag 2023; ahead-of-print. [PMID: 38057278 DOI: 10.1108/jhom-03-2023-0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
PURPOSE Drawing on the experiences of healthcare professionals in one paediatric hospital, this paper explores the influence of context and organisational behaviour on the implementation of a person-centred transition programme for adolescents and young adults (AYA) with long-term conditions. DESIGN/METHODOLOGY/APPROACH A single embedded qualitative case study design informed by a realist evaluation framework, was used. Participants who had experience of implementing the transition programme were recruited from across seven individual services within the healthcare organisation. The data were gathered through semi-structured interviews (n = 20) and analysed using thematic analysis. FINDINGS Implementation of the transition programme was influenced by the complex interaction of macro, meso and micro processes and contexts. Features of organisational behaviour including routines and habits, culture, organisational readiness for change and professional relationships shaped professional decision-making around programme implementation. ORIGINALITY/VALUE There exists a significant body of research relating to the role of context and its influence on the successful implementation of complex healthcare interventions. However, within the area of healthcare transition there is little published evidence on the role that organisational behaviour and contextual factors play in influencing transition programme implementation. This paper provides an in-depth understanding of how organisational behaviour and contextual factors affect transition programme implementation.
Collapse
Affiliation(s)
- Julie Feather
- Evaluation and Policy Analysis Unit, Edge Hill University, Ormskirk, UK
| | - Axel Kaehne
- Medical School, Edge Hill University, Ormskirk, UK
| | - Joann Kiernan
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| |
Collapse
|
5
|
Yap NYS, Patil P, Phoenix C, Russell KB, Lewis C, Yates R, Kelsall W. Successful transition for adolescent survivors of CHD: the Cambridge cardiac transition pathway. Cardiol Young 2023; 33:2639-2643. [PMID: 37127728 DOI: 10.1017/s1047951123000902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE National standards to ensure effective transition and smooth transfer of adolescents from paediatric to adult services are available but data on successful transition in CHD are limited. The aim of this study is to assess the effectiveness of our transition pathway. METHODS Adolescents with CHD, aged 15-19 years, who attended the joint cardiac transition clinic between 2009 and 2018 were identified from the Patient Administration Systems. Patient attendance at their first adult CHD service appointment at Royal Papworth Hospital was recorded. RESULTS 179 adolescents were seen in the joint cardiac transition clinic in the 9-year study period. The median age of the patients when seen was 16 (range 15-19) years. 145 patients were initially planned for transfer to the Royal Papworth Hospital adult CHD service. Three patients were subsequently excluded and the success of the transfer of care in 142 patients were analysed. 112 (78%) attended their first follow-up in the adult CHD clinic as planned, 28 (20%) attended after reminders were sent out with 5/28 requiring multiple reminders, and only 2 (1.4%) failed to attend. Overall, transfer of care was achieved in 140 (98.6%) patients. CONCLUSION A dedicated joint cardiac transition clinic involving multi-professional medical and nursing teams from paediatric and adult cardiology services appears to achieve high engagement rates with the adult services. This approach allows a 'face' to be put on a named clinician delivering the adult service and should be encouraged.
Collapse
Affiliation(s)
- Norah Y S Yap
- Department of Paediatric Cardiology, University Hospital Southampton, Tremona Road, SouthamptonSO16 6YD, England, UK
| | - Parth Patil
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Road, CambridgeCB2 0QQ, England, UK
| | - Carole Phoenix
- Department of Cardiology, Royal Papworth Hospital, Papworth Everard, CambridgeCB23 3RE, England, UK
| | - Katie Bradly Russell
- Department of Paediatrics, Addenbrooke's Hospital, Hills Road, CambridgeCB2 0QQ, England, UK
| | - Clive Lewis
- Department of Cardiology, Royal Papworth Hospital, Papworth Everard, CambridgeCB23 3RE, England, UK
| | - Robert Yates
- Department of Cardiology, Great Ormond Street Hospital, Great Ormond Street, LondonWC1N 3JH, England, UK
| | - Wilf Kelsall
- Department of Paediatrics, Addenbrooke's Hospital, Hills Road, CambridgeCB2 0QQ, England, UK
| |
Collapse
|
6
|
Fegran L, Westergren T, Hall EOC, Aagaard H, Ludvigsen MS. Nurses' and Doctors' Experiences of Transferring Adolescents or Young Adults With Long-Term Health Conditions From Pediatric to Adult Care: A Metasynthesis. Glob Qual Nurs Res 2023; 10:23333936231189568. [PMID: 37561016 PMCID: PMC10408318 DOI: 10.1177/23333936231189568] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 06/26/2023] [Accepted: 07/07/2023] [Indexed: 08/11/2023] Open
Abstract
The transfer of adolescents and young adults (AYA) with long-term health conditions from pediatric to adult care is a multidisciplinary enterprise where nurses and doctors play an important role. This review aimed to identify and synthesize evidence from qualitative primary reports on how nurses and doctors experience the transfer of AYA aged 13 to 24 years with long-term health conditions to an adult hospital setting. We systematically searched seven electronic databases for reports published between January 2005 and November 2021 and reporting nurses' and doctors' experiences. We meta-summarized data from 13 reports derived from 11 studies published worldwide. Using qualitative content analysis, we metasynthesized nurses' and doctors' experiences into the theme "being boosters." Boosting AYA's transfer was characterized by supporting AYA's and their parents' changing roles, smoothening AYA's transition from pediatric to adult care, and handling AYA's encounters with a different care culture.
Collapse
Affiliation(s)
- Liv Fegran
- University of Agder, Kristiansand, Norway
| | - Thomas Westergren
- University of Agder, Kristiansand, Norway
- University of Stavanger, Norway
| | | | - Hanne Aagaard
- Lovisenberg diaconal University College, Oslo, Norway
| | | |
Collapse
|
7
|
McGrath D, O’Halloran P, Prue G, Brown M, Millar J, O’Donnell A, McWilliams L, Murphy C, Hinds G, Reid J. Exercise Interventions for Women with Ovarian Cancer: A Realist Review. Healthcare (Basel) 2022; 10:healthcare10040720. [PMID: 35455897 PMCID: PMC9024745 DOI: 10.3390/healthcare10040720] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/25/2022] [Accepted: 04/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Despite evidence indicating the benefits of exercise interventions for women with ovarian cancer both during and following treatment, uptake is poor. There is limited research exploring the implementation of such interventions for this cohort of women. The purpose of this review was to identify implementation theories in relation to exercise interventions for women with stages I–IV ovarian cancer, both during and following treatment; to explain positive and negative contextual factors, which may help or hinder implementation; and to develop a theory on how exercise interventions for women with ovarian cancer may be implemented. Methods: This realist review sourced literature from five electronic databases: CINAHL plus, Medline, Embase, PsycINFO and Google Scholar. Methodological rigour was assessed using the relevant critical appraisal skills programme tools. Results: Nine papers were included. Two intervention stages were identified: first, optimising uptake by providing education to patients on the benefits of exercise, approaching patients when symptoms are adequately managed and offering a personalised exercise programme; second, adherence and retention are influenced by the provision of an “autoregulated” exercise programme with additional supportive infrastructure, individualised goal setting and symptom management support where required. Conclusion: Women with ovarian cancer are reluctant to engage in exercise interventions, despite the supporting evidence in terms of positive clinical outcomes. This realist review elucidates underlying mechanisms and important contextual factors that will support and guide the implementation of exercise interventions for this cohort of women.
Collapse
Affiliation(s)
- Deirdre McGrath
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (P.O.); (G.P.); (M.B.); (J.R.)
- Correspondence:
| | - Peter O’Halloran
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (P.O.); (G.P.); (M.B.); (J.R.)
| | - Gillian Prue
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (P.O.); (G.P.); (M.B.); (J.R.)
| | - Malcolm Brown
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (P.O.); (G.P.); (M.B.); (J.R.)
| | - Joanne Millar
- Belfast City Hospital, Belfast Health and Social Care Trust, Belfast BT9 7AB, UK; (J.M.); (A.O.); (L.M.); (G.H.)
| | - Adrina O’Donnell
- Belfast City Hospital, Belfast Health and Social Care Trust, Belfast BT9 7AB, UK; (J.M.); (A.O.); (L.M.); (G.H.)
| | - Lisa McWilliams
- Belfast City Hospital, Belfast Health and Social Care Trust, Belfast BT9 7AB, UK; (J.M.); (A.O.); (L.M.); (G.H.)
| | | | - Gwyneth Hinds
- Belfast City Hospital, Belfast Health and Social Care Trust, Belfast BT9 7AB, UK; (J.M.); (A.O.); (L.M.); (G.H.)
| | - Joanne Reid
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (P.O.); (G.P.); (M.B.); (J.R.)
| |
Collapse
|
8
|
Jarvis S, Richardson G, Flemming K, Fraser L. Estimation of age of transition from paediatric to adult healthcare for young people with long term conditions using linked routinely collected healthcare data. Int J Popul Data Sci 2021; 6:1685. [PMID: 34805553 PMCID: PMC8576739 DOI: 10.23889/ijpds.v6i1.1685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Introduction Healthcare transitions, including from paediatric to adult services, can be disruptive and cause a lack of continuity in care. Existing research on the paediatric-adult healthcare transition often uses a simple age cut-off to assign transition status. This risks misclassification bias, reducing observed changes at transition (adults are included in the paediatric group and vice versa) possibly to differing extents between groups that transition at different ages. Objective To develop and assess methods for estimating the transition point from paediatric to adult healthcare from routine healthcare records. Methods A retrospective cohort of young people (12 to 23 years) with long term conditions was constructed from linked primary and secondary care data in England. Inpatient and outpatient records were classified as paediatric or adult based on treatment and clinician specialities. Transition point was estimated using three methods based on record classification (First Adult: the date of first adult record; Last Paediatric: date of last paediatric record; Fitted: a date determined by statistical fitting). Estimated transition age was compared between methods. A simulation explored impacts of estimation approaches compared to a simple age cut-off when assessing associations between transition status and healthcare events. Results Simulations showed using an age-based cut-off at 16 or 18 years as transition point, common in research on transition, may underestimate transition-associated changes. Many health records for those aged <14 years were classified as adult, limiting utility of the First Adult approach. The Last Paediatric approach is least sensitive to this possible misclassification and may best reflect experience of the transition. Conclusions Estimating transition point from routine healthcare data is possible and offers advantages over a simple age cut-off. These methods, adapted as necessary for data from other countries, should be used to reduce risk of misclassification bias in studies of transition in nationally representative data.
Collapse
Affiliation(s)
- Stuart Jarvis
- Martin House Research Centre, Department of Health Sciences University of York, United Kingdom
| | | | - Kate Flemming
- Department of Health Sciences, University of York, United Kingdom
| | - Lorna Fraser
- Martin House Research Centre, Department of Health Sciences University of York, United Kingdom
| |
Collapse
|
9
|
Bowers AP, Bradford N, Chan RJ, Herbert A, Yates P. Analysis of health administration data to inform health service planning for paediatric palliative care. BMJ Support Palliat Care 2020; 12:e671-e679. [PMID: 33051310 DOI: 10.1136/bmjspcare-2020-002449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/27/2020] [Accepted: 09/15/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Health service planning in paediatric palliative care is complex, with the diverse geographical and demographic characteristics adding to the challenge of developing services across different nations. Accurate and reliable data are essential to inform effective, efficient and equitable health services. AIM To quantify health service usage by children and young people aged 0-21 years with a life-limiting condition admitted to hospital and health service facilities in Queensland, Australia during the 2011 and 2016 calendar years, and describe the clinical and demographic characteristics associated with health services usage. DESIGN Retrospective health administrative data linkage of clinical and demographic information with hospital admissions was extracted using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision Australian Modification (ICD-10-AM) diagnostic codes. Data were analysed using descriptive statistics. SETTING/PARTICIPANTS Individuals aged 0-21 years with a life-limiting condition admitted to a Queensland Public Hospital and Health Service or private hospital. RESULTS Hospital admissions increased from 17 955 in 2011 to 23 273 in 2016, an increase of 5318 (29.6%). The greatest percentage increase in admissions were for those aged 16-18 years (58.1%, n=1050), and those with non-oncological conditions (36.2%, n=4256). The greatest number of admissions by ICD-10-AM chapter for 2011 and 2016 were by individuals with neoplasms (6174, 34.4% and 7206, 31.0% respectively). Overall, the number of admissions by Indigenous children and young people increased by 70.2% (n=838). CONCLUSIONS Administrative data are useful to describe clinical and demographic characteristics and quantify health service usage. Available data suggest a growing demand for health services by children eligible for palliative care that will require an appropriate response from health service planners.
Collapse
Affiliation(s)
- Alison Pauline Bowers
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia .,Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Centre for Children's Health Research, Queensland University of Technology (QUT), South Brisbane, Queensland, Australia
| | - Natalie Bradford
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Centre for Children's Health Research, Queensland University of Technology (QUT), South Brisbane, Queensland, Australia
| | - Raymond Javan Chan
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Anthony Herbert
- Paediatric Palliative Care, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Patsy Yates
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Centre for Children's Health Research, Queensland University of Technology (QUT), South Brisbane, Queensland, Australia
| |
Collapse
|
10
|
Bowers AP, Chan RJ, Herbert A, Yates P. Estimating the prevalence of life-limiting conditions in Queensland for children and young people aged 0-21 years using health administration data. AUST HEALTH REV 2020; 44:630-636. [PMID: 32684245 DOI: 10.1071/ah19170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 11/01/2019] [Indexed: 11/23/2022]
Abstract
Objective The prevalence of life-limiting conditions in children in Australia is unknown; such data are needed to inform health service planning for paediatric palliative care. The aim of this study was to estimate the prevalence of life-limiting conditions for children and young people aged 0-21 years living in Queensland, Australia. Methods An observational study using linked administrative health data from the 2011 and 2016 calendar years was performed for all individuals with an International Statistical Classification of Diseases and Related Health Problems 10th Revision Australian Modification code relating to a life-limiting condition eligible for palliative care recorded against an admission to a public or private hospital and health service provider in Queensland or against a cause or underlying cause of death in the Queensland Registrar General Deaths. Results The overall prevalence of life-limiting conditions per 10000 population increased from 35.2 (95% confidence interval (CI) 34.2-36.2) in 2011 to 43.2 (95% CI 42.1-44.4) in 2016. This increase in prevalence was greatest for children <1 year of age and for those who identified as Aboriginal and Torres Strait Islander. Conclusion This study has estimated the prevalence of life-limiting conditions for children and young people aged 0-21 years living in Queensland. Estimation of the number of children and young people with life-limiting conditions can inform health service planning for paediatric palliative care in Queensland. Future research is needed to identify the number of children and young people with life-limiting conditions who do not have an admitted episode. What is known about the topic? Data from the UK indicate that the prevalence of life-limiting conditions among children and young people is increasing. However, such data are not available for the Australian population. Because prevalence data can be affected by population characteristics, it is important to establish country-specific epidemiological data rather than extrapolating data from other countries. Country-specific data can inform health planners and policy makers of the scale of the problem within a geographical and demographic context. This is essential for Australia given the diverse geographical and demographic characteristics and specific needs of Aboriginal and Torres Strait Islander peoples. What does this paper add? This study is the first to provide an estimate of the prevalence of life-limiting conditions in children and young people aged 0-21 years in Queensland. Estimates include the prevalence of life-limiting conditions in children and young people who identify as being of Aboriginal and/or Torres Strait Islander descent. What are the implications for practitioners? The prevalence of life-limiting conditions in Queensland is greater than previously thought. There is a need to grow both a generalist and specialist paediatric palliative care workforce in response to this increasing prevalence. The estimates of prevalence proportions from this study provide the foundation on which future health service activities can be built because they provide country-specific clinical and demographic characteristics.
Collapse
Affiliation(s)
- Alison P Bowers
- School of Nursing, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia; and Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia; and Centre for Children's Health Research at Institute of Health and Biomedical Innovation, Queensland University of Technology, 62 Graham Street, South Brisbane, Qld 4101, Australia; and Corresponding author.
| | - Raymond J Chan
- School of Nursing, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia; and Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia; and Present address: Division of Cancer Services, Princess Alexandra Hospital, Metro South Health, 199 Ipswich Road, Woolloongabba, Qld 4102, Australia.
| | - Anthony Herbert
- School of Nursing, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia; and Centre for Children's Health Research at Institute of Health and Biomedical Innovation, Queensland University of Technology, 62 Graham Street, South Brisbane, Qld 4101, Australia; and Present address: Paediatric Palliative Care Service, Children's Health Queensland Hospital and Health Service, Queensland Children's Hospital, 501 Stanley Street, South Brisbane, Qld 4101, Australia.
| | - Patsy Yates
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia; and Centre for Children's Health Research at Institute of Health and Biomedical Innovation, Queensland University of Technology, 62 Graham Street, South Brisbane, Qld 4101, Australia; and Present address: Queensland University of Technology, O Block, D Wing, Level 7, Kelvin Grove, Qld 4059, Australia.
| |
Collapse
|
11
|
Kerr H, Widger K, Cullen-Dean G, Price J, O’Halloran P. "Transition from children's to adult services for adolescents/young adults with life-limiting conditions: developing realist programme theory through an international comparison". BMC Palliat Care 2020; 19:115. [PMID: 32731863 PMCID: PMC7393825 DOI: 10.1186/s12904-020-00620-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 07/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Managing transition of adolescents/young adults with life-limiting conditions from children's to adult services has become a global health and social care issue. Suboptimal transitions from children's to adult services can lead to measurable adverse outcomes. Interventions are emerging but there is little theory to guide service developments aimed at improving transition. The Transition to Adult Services for Young Adults with Life-limiting conditions (TAYSL study) included development of the TASYL Transition Theory, which describes eight interventions which can help prepare services and adolescents/young adults with life-limiting conditions for a successful transition. We aimed to assess the usefulness of the TASYL Transition Theory in a Canadian context to identify interventions, mechanisms and contextual factors associated with a successful transition from children's to adult services for adolescents/young adults; and to discover new theoretical elements that might modify the TASYL Theory. METHODS A cross-sectional survey focused on organisational approaches to transition was distributed to three organisations providing services to adolescents with life-limiting conditions in Toronto, Canada. This data was mapped to the TASYL Transition Theory to identify corresponding and new theoretical elements. RESULTS Invitations were sent to 411 potentially eligible health care professionals with 56 responses from across the three participating sites. The results validated three of the eight interventions: early start to the transition process; developing adolescent/young adult autonomy; and the role of parents/carers; with partial support for the remaining five. One new intervention was identified: effective communication between healthcare professionals and the adolescent/young adult and their parents/carers. There was also support for contextual factors including those related to staff knowledge and attitudes, and a lack of time to provide transition services centred on the adolescent/young adult. Some mechanisms were supported, including the adolescent/young adult gaining confidence in relationships with service providers and in decision-making. CONCLUSIONS The Transition Theory travelled well between Ireland and Toronto, indicating its potential to guide both service development and research in different contexts. Future research could include studies with adult service providers; qualitative work to further explicate mechanisms and contextual factors; and use the theory prospectively to develop and test new or modified interventions to improve transition.
Collapse
Affiliation(s)
- Helen Kerr
- School of Nursing and Midwifery, Queen’s University Belfast, Medical Biology Centre, Lisburn Road, Belfast, BT9 7BL Northern Ireland
| | - Kimberley Widger
- University of Toronto, Lawrence S Bloomberg John Hopkins University Baetjer Memorial Library, The Hopsital for Sick Children, Toronto, Canada
| | | | - Jayne Price
- Faculty of Health, Social Care and Education, Kingston and St George’s University, London, UK
| | - Peter O’Halloran
- School of Nursing and Midwifery, Queen’s University Belfast, Medical Biology Centre, Lisburn Road, Belfast, BT9 7BL Northern Ireland
| |
Collapse
|
12
|
Walton H, Hudson E, Simpson A, Ramsay AIG, Kai J, Morris S, Sutcliffe AG, Fulop NJ. Defining Coordinated Care for People with Rare Conditions: A Scoping Review. Int J Integr Care 2020; 20:14. [PMID: 32607101 PMCID: PMC7319081 DOI: 10.5334/ijic.5464] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 06/01/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION To coordinate care effectively for rare conditions, we need to understand what coordinated care means. This review aimed to define coordinated care and identify components of coordinated care within the context of rare diseases; by drawing on evidence from chronic conditions. METHODS A systematic scoping review. We included reviews that reported or defined and outlined components of coordinated care for chronic or rare conditions. Thematic analysis was used to develop a definition and identify components or care coordination. Stakeholder consultations (three focus groups with patients, carers and healthcare professionals with experience of rare conditions) were held to further explore the relevance of review findings for rare conditions. RESULTS We included 154 reviews (n = 139 specific to common chronic conditions, n = 3 specific to rare conditions, n = 12 both common/rare conditions). A definition of coordination was developed. Components were identified and categorised by those that: may need to be coordinated, inform how to coordinate care, have multiple roles, or that contextualise coordination. CONCLUSIONS Coordinated care is multi-faceted and has both generic and context-specific components. Findings outline many ways in which care may be coordinated for both rare and common chronic conditions. Findings can help to develop and eventually test different ways of coordinating care for people with rare and common chronic conditions.
Collapse
Affiliation(s)
- Holly Walton
- Department of Applied Health Research, University College London, London, UK
| | - Emma Hudson
- Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, Forvie Site, Robinson Way, Cambridge, UK
| | - Amy Simpson
- Department of Applied Health Research, University College London, London, UK
- Genetic Alliance UK, London, UK
| | - Angus I. G. Ramsay
- Department of Applied Health Research, University College London, London, UK
| | - Joe Kai
- School of Medicine, University of Nottingham, Division of Primary Care, Nottingham, UK
| | - Stephen Morris
- Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, Forvie Site, Robinson Way, Cambridge, UK
| | | | - Naomi J. Fulop
- Department of Applied Health Research, University College London, London, UK
| |
Collapse
|
13
|
Cook KA, Bergeron K. Palliative care for young adults with life-limiting conditions: public health recommendations. BMJ Support Palliat Care 2020; 12:e256-e263. [PMID: 32561547 PMCID: PMC9304099 DOI: 10.1136/bmjspcare-2019-002042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 05/11/2020] [Accepted: 05/18/2020] [Indexed: 12/02/2022]
Abstract
Objective To engage young adults (18–35 years of age) with life-limiting neuromuscular conditions, their parents, and health and community providers in the development of a public health approach to palliative care. A public health approach protects and improves health and wellness, maximises the quality of life when health cannot be restored and improves the quality, scope and accessibility of age-appropriate care and services. Methods Group concept mapping (GCM) was used to determine the most important priorities for these young adults. GCM involves three district phases: (1) brainstorming ideas, (2) sorting and rating ideas based on level of importance and (3) analysing and interpreting concepts maps. Online software was used to collect information for phases 1 and 2 and develop concept maps. In phase 3, a face-to-face workshop, participants analysed and interpreted the concept maps. The combination of online and face-to-face research activities offered the needed flexibility for participants to determine when and how to participate in this research. Results Through this three-phase patient engagement strategy, participants generated 64 recommendations for change and determined that improvements to programming, improvements to funding and creating a continuum of care were their most important priorities. Five subthemes of these three priorities and development of the concept map are also discussed. Conclusion This research demonstrates the unique perspectives and experiences of these young adults and offers recommendations to improve services to enhance their health and well-being. Further, these young adults were integral in the development of recommendations for system changes to match their unique developmental needs.
Collapse
Affiliation(s)
- Karen A Cook
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
| | - Kim Bergeron
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| |
Collapse
|
14
|
O'Connell A, Petty J. Preparing young people with complex needs and their families for transition to adult services. Nurs Child Young People 2020; 31:25-31. [PMID: 31468877 DOI: 10.7748/ncyp.2018.e1123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2018] [Indexed: 11/09/2022]
Abstract
Improving survival rates for children and young people with complex health needs requires a robust system for transition to adult services. Effective planning is essential to ensure a smooth transition process that is in the best interests of the young person and their family. This article discusses the needs and requirements for planned and purposeful transition processes to support young people with complex healthcare needs and their families. It considers the preparation of adult services, the team, the young person and their parents in line with an integrated approach and the nurse's role. Recommendations for practice include the necessity for an integrated approach to ensure optimum outcomes and ascertaining the potential value of a nurse-led service in delivering the transition process. A carefully tailored planning strategy should be developed to prepare and support young people with complex health needs through transition.
Collapse
Affiliation(s)
| | - Julia Petty
- Children's nursing, School of Health and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, England
| |
Collapse
|
15
|
Hart LC, Patel-Nguyen SV, Merkley MG, Jonas DE. An Evidence Map for Interventions Addressing Transition from Pediatric to Adult Care: A Systematic Review of Systematic Reviews. J Pediatr Nurs 2019; 48:18-34. [PMID: 31220801 DOI: 10.1016/j.pedn.2019.05.015] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/20/2019] [Accepted: 05/22/2019] [Indexed: 11/28/2022]
Abstract
PROBLEM Adolescents and young adults with chronic illnesses continue to face barriers as they transition from pediatric to adult care. An evidence map can help to identify gaps in the transition literature to determine targets for future research. ELIGIBILITY CRITERIA We searched PubMed, CINAHL, PsycInfo, and Cochrane for systematic reviews published through February 2018. Eligible reviews included at least one comparative study testing a youth-focused intervention for improving transition with at least one quantitative health-related outcome reported. SAMPLE We identified 431 unique reviews in our search, and 37 reviews (containing 71 eligible primary studies) met inclusion criteria. RESULTS Most reviews (20 of 37) summarized some aspect of transition across diagnoses. Type 1 diabetes was the most common diagnosis studied (7 of 37 reviews and 24 of 71 primary studies). Only 14 of 71 primary studies focused on care after transfer to adult care. CONCLUSIONS The literature on interventions to improve transition to adult care has focused on a limited number of diagnoses, most commonly Type 1 diabetes. Common pediatric conditions, such as asthma, have not been studied with regard to transition. Efforts have been mainly targeted on transition preparation, with less focus on transition needs after transfer to adult care. IMPLICATIONS There is a need for transition research focused on common pediatric conditions and transition needs after transfer to adult care.
Collapse
Affiliation(s)
- Laura C Hart
- Nationwide Children's Hospital, Columbus, OH, United States of America; The Ohio State University College of Medicine, Departments of Pediatrics and Medicine, United States of America; The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, United States of America.
| | | | | | - Daniel E Jonas
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, United States of America; University of North Carolina at Chapel Hill, Department of Medicine, United States of America.
| |
Collapse
|
16
|
Kerr H, Price J, O’Halloran P. A cross-sectional survey of services for young adults with life-limiting conditions making the transition from children’s to adult services in Ireland. Ir J Med Sci 2019; 189:33-42. [DOI: 10.1007/s11845-019-02054-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 06/26/2019] [Indexed: 11/29/2022]
|
17
|
Aldiss S, Rose L, McCutcheon D, Cass H, Ellis J, Gibson F. Gathering expert opinion to inform benchmarks to support transitional care. J Child Health Care 2019; 23:131-146. [PMID: 29911431 DOI: 10.1177/1367493518780486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to (1) explore views of known experts leading on transition, (2) gather insights on the essential features of transitional care models and (3) highlight opportunities for and barriers to change: to inform core elements of benchmarks for transitional care. We held three workshops ( n = 20) and used a telephone interview ( n = 1) with health and social care professionals with expertise working with young people with a range of health conditions and disabilities. The workshops included individual brainstorming and group discussion. Data were analysed using qualitative content analysis. The general consensus from stakeholders' discussions about transition was that 'things have become stuck'. Themes included: professionals' attitudes towards and knowledge about young people and transition, organizational barriers and 'lack of joined-up thinking' between services. Our work offers further insight into experts' perceptions of transition services within the United Kingdom. It is clear that there is still much to be done to improve transition, to better meet the needs of young people and parents and begin to offer equitable access to transitional care programmes. The benchmarks offer a starting point for professionals seeking to improve transition through enabling the identification of gaps in services and providing a platform to share successful practice initiatives.
Collapse
Affiliation(s)
- Susie Aldiss
- 1 School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Laura Rose
- 2 University College London Hospital NHS Foundation Trust, London, UK
| | - Dominic McCutcheon
- 3 Department of Nursing and Midwifery, University of the West of England, Bristol, UK
| | - Hilary Cass
- 4 Evelina London Children's Hospital, St Thomas' Hospital, Westminster Bridge Road, London, UK
| | - Judith Ellis
- 5 Royal College of Paediatrics and Child Health, London, UK
| | - Faith Gibson
- 1 School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
- 6 Centre for Outcomes and Experiences Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| |
Collapse
|
18
|
White PH, Cooley WC, Boudreau ADA, Cyr M, Davis BE, Dreyfus DE, Forlenza E, Friedland A, Greenlee C, Mann M, McManus M, Meleis AI, Pickler L, TRANSITIONS CLINICAL REPORT AUTHORING GROUP, AMERICAN ACADEMY OF PEDIATRICS, AMERICAN ACADEMY OF FAMILY PHYSICIANS, AMERICAN COLLEGE OF PHYSICIANS. Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home. Pediatrics 2018; 142:peds.2018-2587. [PMID: 30348754 DOI: 10.1542/peds.2018-2587] [Citation(s) in RCA: 514] [Impact Index Per Article: 73.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Risk and vulnerability encompass many dimensions of the transition from adolescence to adulthood. Transition from pediatric, parent-supervised health care to more independent, patient-centered adult health care is no exception. The tenets and algorithm of the original 2011 clinical report, "Supporting the Health Care Transition from Adolescence to Adulthood in the Medical Home," are unchanged. This updated clinical report provides more practice-based quality improvement guidance on key elements of transition planning, transfer, and integration into adult care for all youth and young adults. It also includes new and updated sections on definition and guiding principles, the status of health care transition preparation among youth, barriers, outcome evidence, recommended health care transition processes and implementation strategies using quality improvement methods, special populations, education and training in pediatric onset conditions, and payment options. The clinical report also includes new recommendations pertaining to infrastructure, education and training, payment, and research.
Collapse
Affiliation(s)
- Patience H. White
- Got Transition/The National Alliance to Advance Adolescent Health and Department of Medicine and Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia; and
| | - W. Carl Cooley
- Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Kerr H, Price J, Nicholl H, O'Halloran P. Facilitating transition from children's to adult services for young adults with life-limiting conditions (TASYL): Programme theory developed from a mixed methods realist evaluation. Int J Nurs Stud 2018; 86:125-138. [PMID: 30005314 DOI: 10.1016/j.ijnurstu.2018.06.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 06/28/2018] [Accepted: 06/29/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Improvements in care and treatment have led to more young adults with life-limiting conditions living beyond childhood, necessitating a transition from children's to adult services. Given the lack of evidence on interventions to promote transition, it is important that those creating and evaluating interventions develop a theoretical understanding of how such complex interventions may work. OBJECTIVES To develop theory about the interventions, and organisational and human factors that help or hinder a successful transition from children's to adult services, drawing on the experience, knowledge, and insights of young adults with life-limiting conditions, their parents/carers, and service providers. DESIGN A realist evaluation using mixed methods with four phases of data collection in the island of Ireland. Phase one: a questionnaire survey of statutory and non-statutory organisations providing health, social and educational services to young adults making the transition from children's to adult services in Northern Ireland and one Health Services Executive area in the Republic of Ireland. Phase two: interviews with eight young adults. Phase three: two focus groups with a total of ten parents/carers. Phase four: interviews with 17 service providers. Data were analysed seeking to explain the impact of services and interventions, and to identify organisational and human factors thought to influence the quality, safety and continuity of care. RESULTS Eight interventions were identified as facilitating transition from children's to adult services. The inter-relationships between these interventions supported two complementary models for successful transition. One focused on fostering a sense of confidence among adult service providers to manage the complex care of the young adult, and empowering providers to make the necessary preparations in terms of facilities and staff training. The other focused on the young adults, with service providers collaborating to develop an autonomous young adult, whilst actively involving parents/carers. These models interact in that a knowledgeable, confident young adult who is growing in decision-making abilities is best placed to take advantage of services - but only if those services are properly resourced and run by staff with appropriate skills. No single intervention or stakeholder group can guarantee a successful transition. Rather, service providers could work with young adults and their parents/carers to consider desired outcomes, and the range of interventions, in light of the organisational and human resources available in their context. This would allow them to supplement the organisational context where necessary and select interventions that are more likely to deliver outcomes in that context.
Collapse
Affiliation(s)
- Helen Kerr
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University, Belfast, Northern Ireland, United Kingdom.
| | - Jayne Price
- Faculty of Health, Social Care and Education, Kingston University and St George's, University London, Kingston Hill Campus, Kingston upon Thames, Surrey, United Kingdom.
| | - Honor Nicholl
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, Ireland.
| | - Peter O'Halloran
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University, Belfast, Northern Ireland, United Kingdom.
| |
Collapse
|
20
|
Abstract
Increased incidence of children diagnosed with cancer and survivors was an impact on changes in pediatric hemato-oncology nursing care. In this review article, it is aimed to investigate the new trends and recent care approaches in pediatric oncology nursing. The recent care topics were common in the literature as family-centered care, technology-based care, program development, primary care of child, health-care provider, survivors and home care, and nonpharmacological care. All of the topics contribute to perform evidence-based care for health promotion and well-being in pediatric hemato-oncology nursing. Research reviews showed that many current topics for the care of children and their parents have entered in the literature. There is a need for more randomized controlled studies to improve the level of evidence of new nursing approaches.
Collapse
Affiliation(s)
| | - Naime Altay
- Department of Nursing, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| |
Collapse
|