METHODS: A systematic literature search was performed in October 2021. Records were screened and identified for studies relevant to reported readiness and experience in urologic transitional care among patients needing life-long urologic care. The methodological quality of the cross-sectional studies was assessed using AXIS. The included studies were clustered according to patient readiness in transition and patient experience-satisfaction in the urologic transition process. This scoping review was part of a systematic review registered on PROSPERO CRD42022306229 and was conducted in compliance with the PRISMA extension for scoping reviews.
RESULTS: A total of 12 articles were included that assessed patients with neurogenic bladder that reported either readiness or patient experience following the transitional care process. The patient readiness was assessed in six studies, determined using the TRAQ score with a range of 3-4/5. Older age, high health literacy, and parental or families\' transition process awareness were associated with readiness. Generally, patients experience better satisfaction with pediatric care than with adult care facilities. Most patients felt that sexuality and fertility were not adequately tackled during the transition. The reported barriers to successful transition were patient, provider, and system factors, including lack of insurance coverage/financial management, patient preference, long-term bond with the pediatric providers, and communication by the adult provider. Based on AXIS, all of the studies identified for this scoping review did not determine the sample size, and most of the studies did not categorize the responders, which could introduce bias to the interpretation of their results.
CONCLUSIONS: This scoping review summarizes the readiness and experience of neurogenic bladder patients who underwent the urologic transitional process. Overall, understanding the patient, provider, and system factors associated with better readiness and enhancing the patient experience will ensure a better transition process.
方法:2021年10月进行了系统的文献检索。在需要终身泌尿外科护理的患者中,筛选并确定了与报告的泌尿外科过渡护理准备和经验相关的研究记录。使用AXIS评估横断面研究的方法学质量。纳入的研究根据患者的过渡准备情况和患者在泌尿外科过渡过程中的经验满意度进行分组。此范围审查是在PROSPEROCRD42022306229上注册的系统审查的一部分,并且是根据PRISMA扩展范围审查进行的。
结果:共纳入12篇文章,对神经源性膀胱患者进行评估,报告了过渡期护理过程后的准备情况或患者经验。在六项研究中评估了患者的准备情况,使用TRAQ评分确定,范围为3-4/5。年纪大了,高健康素养,父母或家庭的过渡过程意识与准备情况有关。一般来说,与成人护理设施相比,患者对儿科护理的满意度更高。大多数患者认为在过渡期间没有充分解决性行为和生育能力。据报道,成功过渡的障碍是病人,提供者,和系统因素,包括缺乏保险/财务管理,患者偏好,与儿科提供者的长期联系,和成人提供者的沟通。基于AXIS,本次范围审查确定的所有研究都没有确定样本量,大多数研究没有对反应者进行分类,这可能会给他们的结果的解释带来偏见。
结论:本范围综述总结了接受泌尿外科过渡过程的神经源性膀胱患者的准备情况和经验。总的来说,了解病人,提供者,与更好的准备和增强患者体验相关的系统因素将确保更好的过渡过程。