Experiences of adolescents with type 1 diabetes, their parents, and health care providers during the transition to adult health care settings: a qualitative systematic review
Year: 2025
Type: review
Study design: Systematic Review
Abstract: OBJECTIVE: The objective of this qualitative review was to identify and synthesize the evidence related to the experiences and perspectives of adolescents with type 1 diabetes (T1D), their parents, and health care providers (HCPs) on the transition from pediatric to adult health care settings. INTRODUCTION: Transition to adult health care is one of the challenges facing adolescents with T1D, and unsuccessful transitions can lead to negative health outcomes. Understanding the perspectives of adolescents and young adults, their parents, and health care professionals on the transition is essential to develop effective transition interventions. ELIGIBILITY CRITERIA: Studies were considered for inclusion if they explored the experiences and perspectives of adolescents with T1D, their parents, and HCPs on the transition from pediatric to adult health care settings. This review included studies that focused on qualitative data, including designs such as phenomenology, grounded theory, ethnography, and qualitative descriptive. METHODS: MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), CINAHL (EBSCOhost), Cochrane Library, and PubMed were searched to identify published studies from inception to May 2024. There was no restriction on the date or language of the publication. The conduct of the review adhered to the JBI methodology for qualitative systematic reviews. The JBI process of meta-aggregation was used to identify categories and synthesize findings. RESULTS: Of 6303 records identified, 25 studies met the eligibility criteria and were included in the review. The included studies represented the perspectives of 486 adolescents and young adults receiving care in either pediatric or adult health care settings, 86 parents, and 81 HCPs working in either pediatric or adult health care settings. In most studies, interviews were used as the method for data collection. A total of 159 findings were extracted and aggregated into 12 categories, based on the similarity of meaning. Five synthesized findings were generated, all with moderate confidence: i) Adolescents and young adults with T1D may be anxious and feel unprepared due to being unaware of the process and a lack of preparation; however, others may be confident and ready for their transition to adult services; ii) Adolescents with T1D face many barriers as they transition from pediatric to adult care, mainly due to challenges of navigating changes in health systems or the burden of living with T1D; iii) A successful transition to adult care for adolescents and young adults with T1D depends on activities to support feeling prepared for the transition, having support networks with a stronger emphasis on peer support, and a structured and coordinated transition between pediatric and adult health care; iv) Parents can struggle with their child's transition where the parents' roles and responsibilities are refined by their children as they approach adulthood, and parents may need support to address their new role during transition; and v) HCPs can be uncertain of the best transition strategy and tend to suggest many activities to improve transition, mainly focusing on coordination between pediatric and adult health care. CONCLUSION: The findings of this qualitative review offer insight into the perspectives of adolescents with T1D, parents, and HCPs on the transition from pediatric to adult health care settings. The findings highlighted the need for more structured transition processes that empower autonomy and self-management skills of young adults, along with continuous support from parents and HCPs. REVIEW REGISTRATION: PROSPERO CRD42024557117.
Source: JBI Evidence Synthesis
Authors: Mariam G. Ahmed, Emma Wilson, Heather Buchanan, Fatin Pakururazi, James Law, Jo Leonardi-Bee
Language: English
Subfield: Speech and Hearing
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4415477486