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

Journal Title

Journal ISSN

Volume Title

Publisher

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.

Description

Keywords

youth, spina bifida, literature review

Citation