Transition to adulthood for young people with medical complexity: an integrative literature review

Date

2014-12-22

Authors

Joly, Elizabeth

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Abstract

Due to medical and technological advances over the last several decades and increases in survival rates, many young people with medical complexity are surviving into adulthood. Over the last decade, there has been an explosion of literature focusing on the transition to adulthood for young people with chronic conditions, but with proportionately little focus on this complex population. This project explores how existing empirical literature on the transition to adulthood for young people with medical complexity can inform Advanced Practice Nurses (APNs) using Whittemore and Knafl’s integrative literature review approach. Cohen and colleagues’ definitional framework was used to define medical complexity. This review was further informed by Meleis’ Transition Theory and Bronfenbrenner’s Bioecological Theory of Human Development. Three themes emerged from the data synthesized from 10 qualitative and one quantitative study: it’s like falling off a cliff, the paradox of independence, and it takes a village. The findings of this review generally supported and were supported by the theoretical perspectives that informed this review; however, the findings also emphasized the unique nature of proximal processes and developmental trajectories of young people with medical complexity. Recommendations for APNs based on the findings focus on advocacy, capacity-building, education, and program development and evaluation. The findings of this review also illuminated the existence of ethical issues in transition and the necessity of systems leadership for policy change. Finally, recommendations for future research are offered with a focus on determinants of health, psychosocial concerns, parent needs and future planning, and program development and evaluation.

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Keywords

transition, adolescent, young adult, complex chronic conditions, literature review

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