Abstract
Binks JA, Barden WS, Burke TA, Young NL. What do we really know about the transition
to adult-centered health care? A focus on cerebral palsy and spina bifida.
Objectives
To address the lack of synthesis regarding the factors, processes, and outcomes specific
to the transition from child-centered to adult-centered health care for people with
cerebral palsy (CP) and spina bifida (SB); more specifically, to identify barriers,
to outline key elements, to review empirical studies, and to make clinical and research
recommendations.
Data Sources
We searched Medline and CINAHL databases from 1990 to 2006 using the key words: transition, health care transition, pediatric health care, adult health care, health care access, health care use, chronic illness, special health care needs, and physical disability. The resulting studies were reviewed with a specific focus on clinical transition
for persons with CP and SB, and were supplemented with key information from other
diagnostic groups.
Study Selection
All studies meeting the inclusion criteria were included.
Data Extraction
Each article classified according to 5 criteria: methodology, diagnostic group, country
of study, age group, and sample size.
Data Synthesis
We identified 149 articles: 54 discussion, 21 case series, 28 database or register,
25 qualitative, and 34 survey articles (some included multiple methods). We identified
5 key elements that support a positive transition to adult-centered health care: preparation,
flexible timing, care coordination, transition clinic visits, and interested adult-centered
health care providers. There was, however, limited empirical evidence to support the
impact of these elements.
Conclusions
This review summarizes key factors that must be considered to support this critical
clinical transition and sets the foundation for future research. It is time to apply
prospective study designs to evaluate transition interventions and determine long-term
health outcomes.
Key Words
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Article info
Footnotes
See commentary p 1080.
Supported by the Canadian Institutes of Health Research and a Canada Research Chair in Rural and Northern Children’s Health, Canadian Institutes of Health Research.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
Identification
Copyright
© 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
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Access this article on ScienceDirectLinked Article
- Perspectives on Transitions: Rethinking Services for Children and Youth With Developmental DisabilitiesArchives of Physical Medicine and RehabilitationVol. 88Issue 8
- PreviewRosenbaum P, Stewart D. Perspectives on transitions: rethinking services for children and youth with developmental disabilities. Transition to adulthood for youth with developmental disabilities has become an important concern internationally of service providers working with these young people. Reflecting on the useful review by Binks and colleagues in this issue of the Archives, we argue as developmentalists that this is an ideal time to step back from our traditional preoccupation with “treatment” of childhood disability and to reconsider broadly what our goals for intervention ought to be.
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