Youths' Experiences of Transition from Pediatric to Adult Care: An Updated Qualitative Metasynthesis

• Published in: Journal of pediatric nursing 2020-11, Vol.55, p.201-210
• Main Authors: Varty, Maureen, Speller-Brown, Barbara, Phillips, Leslie, Kelly, Katherine Patterson
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents and young adults; Child; Chronic Disease; Delivery of Health Care; Humans; Parents; Qualitative metasynthesis; Qualitative Research; Transition; Transition readiness; Transition to Adult Care; Young Adult
• ISSN: 0882-5963; 1532-8449
• DOI: 10.1016/j.pedn.2020.08.021

Improvements in chronic disease management has led to increasing numbers of youth transitioning to adult healthcare. Poor transition can lead to high risks of morbidity and mortality. Understanding adolescents and young adults (AYA) perspectives on transition is essential to developing effective transition preparation. The aim of this metasynthesis was to synthesize qualitative studies assessing the experiences and expectations of transition to adult healthcare settings in AYAs with chronic diseases to update work completed in a prior metasynthesis by Fegran, Hall, Uhrenfeldt, Aagaard, and Ludvigsen (2014). A search of PubMed, Medline, PsycINFO, and CINAHL was conducted to gather articles published after February 2011 through June 2019. Of 889 articles screened, a total of 33 articles were included in the final analysis. Seven main themes were found: developing transition readiness, conceiving expectations based upon pediatric healthcare, transitioning leads to an evolving parent role, transitioning leads to an evolving youth role, identifying barriers, lacking transition readiness, and recommendations for improvements. Findings of this metasynthesis reaffirmed previous findings. AYAs continue to report deficiencies in meeting the Got Transition® Six Core Elements. The findings highlighted the need to create AYA-centered transition preparation which incorporate support for parents. Improvements in transition preparation interventions need to address deficiencies in meeting the Got Transition® Six Core Elements. More research is needed to identify and address barriers implementing the transition process. •AYAs report transition processes are deficient in meeting the Got Transition® Six Core Elements.•Healthcare providers must design system processes to provide resources necessary for transition.•Research identifying family processes to support AYA assumption of responsibility is needed.•Several evidence-based recommendations are ready for implementation as confirmed by findings.