Pediatric Healthcare Associates – This population, which is growing in number, often requires lifelong health care services. Between 2011 and 2017, approximately 4.5 million young people aged 12-18 years with special health care needs were transferred from doctors to adults and facilities treatment.
These transitions are often difficult and can lead to a lack of care, poor health, and stress for patients and families.
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One of the reasons the transition from pediatric to adult health services is so difficult is the lack of clarity about how to best manage them. In 2011, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians sought to address this issue by publishing guidelines for implementing early-onset youth interventions.
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After that, Get Transferred (government funded by the federal agency for health services) developed a medical system for transferring patients from children to people. old medical services. This approach, called the “Six Core Elements of Health Care Transition,” includes: policy change, tracking and monitoring change, change management, change planning, change perspective check and change complete.
Health care professionals use a variety of methods to integrate the Six Keys, including direct intervention for health care reform with children and their caregivers. reviews, strategies such as physician training, and tools to facilitate communication between physicians and the elderly. However, the broad scope of the Six Core Elements has raised questions about the best change interventions and tools and strategies. In addition, the question continues about how certain changes can affect the benefits and harms of specific procedures, and how these procedures can be modified accordingly. the need. Factors that may influence outcome are patient characteristics (eg, age, race, type of disease), physician/hospital characteristics (eg , access to specialized services, specialized training) and place of care (eg, specialty center, telemedicine). Identifying and understanding intervention factors that lead to better outcomes will help patients, caregivers, and physicians make more informed decisions about interventions. (or products) will work for whom and under what circumstances.
The product is constantly being affected. Instead, interventions differ in their properties, structure, and methods. For this reason, we do not strictly define or describe the possibility of interventions that we may encounter in the data, and we do not include interventions to change care. Readers interested in learning more about potential transitions are encouraged to explore the Got Transitions website.
The National Cancer Institute (NCI) requested this review as part of the Childhood Cancer Survivorship, Treatment, Access, and Research (STAR) Act, which is dedicated to supporting the state of research and development of health and quality of life for children and young people with cancer. As the NCI is expected to conduct research specifically addressing health care reform for children and youth with childhood cancer, the review will examine changes to for adult care for all children with special medical needs. Key considerations to be addressed by the review include the effectiveness and harms of (1) health care targeting children in need of treatment; specifically and their families/caregivers, (2) strategies to implement interventions for health change including training of health care providers. , and (3) tools to facilitate communication between health professionals and the elderly.
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The key question (KQ) addresses the impact of intervention on the transition from pediatric to adult services for children with special medical needs. Health care reform can be complex or multifaceted, when there is a change in the behavior of patients and doctors. Therefore, we include questions to help understand the issues and advocates for these interventions. Contextual questions will support and inform the analysis by providing information about the content in the clinical course of change.
We did not make changes to the main questions in response to public comments (n=2). Most of the comments will be made as a decision in the context of the content and will depend on the area of the document.
In addition to the key questions identified, the NCI has expressed interest in a mixed-methods approach to evaluating content that is relevant to the transition of children with special medical needs. from doctors to the elderly have been developed and used. Questions to be evaluated include:
We will prioritize the collection of information for the population that predicts the best treatment of children and young people with cancer. However, the data may include many health care providers, including primary care/family physicians, specialists, physicians, nurses, and others. social work. Note that in Table 1, the results are summarized to correspond with the main question. Importantly, the final results recorded will depend on the results reported in the individual studies and the interventions and measures used by the study authors.
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Adolescents and young adults (diagnosed with cancer or other medical conditions before age 21) with chronic illness or mental or physical, intellectual, or developmental disabilities, including mothers father and/or guardian.
Patient groups: disease (eg cancer), age at diagnosis, gender/sexual orientation, race/ethnicity, religion, economic status in society, the conditions are not good for children.
Multidisciplinary health care providers (such as primary care/family physicians, specialists, physicians, nurses, etc.) care for adolescents and children young women who need special treatment.
Multidisciplinary physicians (e.g. primary care/family physicians, specialists, physicians, nurses, etc.) youth and youth with special needs.
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Interventions related to the transition of care from the physician to the treatment of the elderly (eg, a single intervention or multiple interventions that address the Six Core Elements of health reforms such as curriculum, nursing materials, procedures, etc. packages of intervention products; interventions vary in their products , models, and methods.) No health reform interventions were excluded. However, changes that refer to all changes to the elderly’s life, such as the transition to living independently from care or from the elderly unable to grow, will be excluded.
Implementation of strategies, including training (eg, a single intervention or multiple interventions that address the implementation of the Six Core Elements of health reform such as training show).
Tools for practitioner communication (eg, a single or multi-point intervention that addresses communication that supports the Six Key Principles of health care reform such as nursing records).
At least 6 months after the transition for intervention trials. There are no exclusions for qualitative studies or combinations for problems and subquestion programs.
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At least 6 months for intervention testing. There are no exclusions for qualitative studies or combinations for problems and subquestion programs.
Figure 1 shows a visual representation of the analytical model for the KQ’s, showing the relationship between interventions and outcomes.
The studies to be included in the review according to the PICOTS definition are listed above in Table 1 and the specific studies included are described in Table 2.
KQ1: Individuals diagnosed with cancer or other specific medical conditions (diagnosed before age 21) and their parents and/or guardians.
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KQ2-3: General practitioners for individuals diagnosed with cancer or other specific medical conditions (diagnosed before age 21).
CQ1 & CQ5: Individuals diagnosed with cancer or other specific medical conditions (diagnosed before age 21) and their parents and/or guardians.
CQ2–4 & CQ6: General practitioners for individuals diagnosed with cancer or other specific medical conditions (diagnosed before age 21).
KQ1 and CQ1 & CQ5: Assess the effectiveness, comparative effectiveness, harms, and/or costs of care for the transition from children to adults services treatment, exploring the relationship between PICOTS characteristics and outcomes, or the experiences of partners and participants.
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KQ2, CQ2–4: Assess the effectiveness, comparative benefits, harms, and/or costs of health care providers with regard to training and other strategies for reform .
KQ3: Evaluate the effectiveness, compare the benefits, harms, and/or costs of tools to facilitate communication between health professionals and adults for the transition of the child to for adults treating children with special medical needs and their families/caregivers.
KQ questions under a and b: Measure the effect of the intervention identified for KQ1-3 through the intervention characteristics or materials; by patient/caregiver or physician characteristics or settings;
Randomized and non-randomized controlled trials, studies with comparative arms, single arm before/after designs. In addition to qualitative research (eg ethnography, phenomenology, descriptive research, grounded theory, research, qualitative analysis); quantitative non-randomized studies (eg non-randomized controlled trials, cohort studies, case-control studies, cross-sectional studies); Large descriptive studies (e.g. event or multivariate studies without comparison groups, observational studies, data with > 9 participants, data reporting changes exchange of tools, materials, or services); Methods of mixed research (e.g. participatory design, sequential descriptive design, exploratory design)
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Published in peer-reviewed journals and gray papers with full text (if sufficient data are available to assess eligibility and risk of bias). Manuscripts and manuscripts were not included due to the inability of short publications to provide the information needed to fully explain the impact. Recommendations from professional organizations and organizations from the gray literature for questions of content. Individual or small group ideas or opinions will be excluded.
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We will search Ovid Medline, CINAHL, Ovid Embase, and the Cochrane register of Controlled Trials (CENTRAL) to identify published studies and identify them in databases. The search criteria will include administrative terms and natural language terms for terms of care transitions (pediatric to adult), and specific medical needs ( Appendix A). We will add our research ideas as well
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