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Current Pediatric Reviews

Author(s): Tara Mantler*, Kimberley T. Jackson, Jessi Baer, Jenna White, Bridget Ache, Katie Shillington and Nokuzola Ncube

DOI: 10.2174/1573396316666191218102734

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Changes in Care- A Systematic Scoping Review of Transitions for Children with Medical Complexities

Page: [165 - 175] Pages: 11

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Abstract

Background: Children with medical complexity (CMC) and their parents are affected physically and mentally during transitions in care. Coordinated models of care show promise in improving health outcomes.

Objective: The purpose of this scoping review was to examine research related to CMC and their parents and transitions in care. The aim was 3-fold: (1) to examine the extent, range, and nature of research activity related to the impact of transitions on physical and mental health for CMC and their parents; (2) to summarize and disseminate research findings for key knowledge users; and (3) to identify research gaps in the existing literature to inform future studies.

Methods: Twenty-three sources were identified through database searches and five articles met the inclusion criteria of CMC (multi-organ involvement or technology-dependent) (or parents of CMC) transitioning from hospital to alternate levels of care where outcome measures were physical or mental health-related.

Results: Numerical analysis revealed substantial variation in methodological approaches and outcome measures. Content analysis revealed two themes for parents of CMC during this transition: (1) emotional distress, and (2) high expectations; and three themes for CMC: (1) improved health, (2) changes in emotion, and (3) disrupted relationships.

Conclusion: The findings from this scoping review reveal for parents, transitions in care are fraught with emotional distress and high expectations; and for CMC there are improvements in quality of life and emotional health post- hospital to home transitions when collaborative models of care are available. This review serves as an early attempt to summarize the literature and demonstrate a need for further research.

Keywords: Children with medical complexity, CMC, transitions in care, physical health, mental health, caregivers.

Graphical Abstract

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