Transition from pediatric to adult care for youth with spina bifida: an integrative literature review and implications for the clinical nurse specialist role
Date
2013-08-21
Authors
Todt, Ashley
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Abstract
As a direct result of advances in medicine and surgical interventions, youth with spina
bifida are now living well into adulthood (Sandler, 2010). As a result, a new healthcare priority
has emerged: facilitating an effective transition from pediatric to adult care. Primary goals for
transition preparation includes facilitating increased self-management, independence, and
obtaining adequate follow-up services for individuals with chronic health care needs to ensure
youth are adequately prepared for the adult health care system, and able to manage their own
care (Canadian Pediatric Society, 2007; Blum et al., 1993).
I conducted an integrative review to learn about the transition from pediatric to adult care
for youth with spina bifida in order to identify implications for the clinical nurse specialist (CNS)
role. As a result, I have learned that while transition programs are in existence, (a) selfmanagement
skills, (b) independence, and (c) adult medical follow-up are lacking in young
adults with spina bifida, and that (d) general health status decreases from youth to adulthood in
this population. The CNS can utilize the theoretical framework of the Chronic Care Model (The
MacColl Center, 1996-2003) and Meleis’ Middle Range Transition Theory (Meleis, 2000) to
create a transition program and plan tailored interventions to facilitate an effective transition
from pediatric to adult care for this population. I developed a draft transition program outline
that addresses the issues I identified for this population in the review, such as enhancing
communication between pediatric and adult services, and utilizing a stepwise approach of
increasing self-management skills. Through creating, implementing and evaluate a transition
program like the one I designed, the CNS has the ability to improve the care of youth
transitioning from pediatric to adult care and impact their health outcomes, independence, and
social participation.
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Keywords
youth, spina bifida, literature review