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Letting go/ moving on: A scoping review of relational effects on transition to adult care
Susan Shanske1, Janis Arnold1, Judy Bond1
1Department of Social Work, Boston Children's Hospital, USA.
Insights
This review found that relationships between pediatric providers and patients/families are often cited as barriers to transitioning to adult care. However, these relationships can also facilitate successful transitions, highlighting their importance in developing interventions.
Area of Science:
- Pediatric Healthcare
- Transition of Care
- Patient-Provider Relationships
Background:
- Relationships between patients, parents, and pediatric providers are frequently identified as barriers during the transition from pediatric to adult healthcare.
- A scoping review was conducted to explore the existing literature on these relationships in the context of healthcare transitions.
Purpose of the Study:
- To assess the extent of literature on how relational components in pediatric care influence the transition process and transfer outcomes.
- To identify studies focusing on the relationship between patients/parents and pediatric providers concerning the transition to adult healthcare.
- To explore the nature and depth of evidence regarding these relationships.
Main Methods:
- A comprehensive search was performed across four databases (PubMed, CINAHL, PsycINFO, Web of Science) using keywords and controlled vocabulary.
- Search terms were developed through medical librarian expertise and expert input.
- Records underwent dual independent review by clinical experts at both screening and full-text stages to minimize bias.
Main Results:
- The initial search yielded 13,121 records, with 152 studies meeting inclusion criteria for both pediatric-to-adult care transition and provider-patient/family relationships.
- A variable amount of research was identified, with limited formal studies on interventions.
- Most studies identified relationship issues as barriers, involving providers, patients, parents, or a combination.
Conclusions:
- The literature indicates that relationships between pediatric providers and patients/families are crucial in the transition to adult care.
- While often cited as barriers, these relationships can also act as facilitators, underscoring their significance for intervention development.
- Further research is needed to formally study interventions that leverage positive relational dynamics.
Objective:
The objective of this scoping review was to assess the extent of the literature on how relational components in pediatric care contribute to the transition process and transfer outcomes.
Background:
Relationships between patients, parents and pediatric providers are a frequently cited barrier in transition to adult care. A scoping review aimed to identify studies focused on how the relationship between patients/parents and pediatric providers related to transition from pediatric to adult healthcare and explore the nature and depth of the evidence.
Methods:
Search terms were identified through a combination of medical librarian term harvesting and expert input. Four databases were searched with a combination of keyword and controlled vocabulary: PubMed, CINAHL, PsycINFO, and Web of Science. In order to reduce the risk of bias, each record was reviewed by two independent clinical experts in both the screening and full-text review stages. No database filters were applied during the searching process.
Results:
The initial search strategy resulted in 13,121 records. After removal of duplicates, 271 moved on to full text review, and 152 met inclusion criteria as related to both transition from pediatric to adult medical care and relationships between pediatric providers and patients/families.
Conclusions:
This scoping review aimed to identify available literature on relationships between pediatric providers and patients/families. Variable levels of research were identified, with little formal study of interventions. The majority described relationship issues as barriers, either on the part of providers, patients, parents or a combination of these. Several highlighted relationship ties as facilitators in the transition, an important consideration in determining interventions.
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