Date of Defense:
July 30, 2014
Objective: Growing numbers of children are surviving into adulthood with child – onset chronic disease and disabilities due to advances in medicine over the last three decades. This transition to adult – oriented care is often known to be disorganized and can result in lack of stream-lined access to healthcare providers and in impaired health and function. Although many youth with special health care needs (YSHCN) benefit from a process that prepares them for eventual transition to adult care, there have been no discernible improvements in many years. Health care providers play an important role within complex systems of care to effectively impact quality of care for these youth. Attitudes and awareness at t he level of the healthcare provider as well as barriers to efficacious HCT will be reviewed and will likely identify areas where improvements can be made.
Methods: A literature review was conducted by searching Pubmed, CHINHL, Medline Ovid, and PSYCHinfo databases for articles published between 1999 and 2013. English language abstracts that discussed topics related to attitudes, awareness, and barriers for health care providers working with YSHCN were reviewed. References were also studied from identified articles for related abstracts. Data from articles selected for full review were represented for each of the three topics on charts.
Results: A total of sixty – three articles were identified and thirty – one were selected for this review. This literature re view yielded three primary themes: awareness, attitudes, and barriers. Topics were woven within articles and often combined. More evidence was elicited of what is known of attitudes of providers toward HCT and of existing barriers. There were few empirical studies.
Conclusions: This literature review provides insight into the various levels of awareness providers have, the types of HCT – related components that affect their attitudes, and the variety of barriers they face. More research needs to be performed to assess how healthcare providers can better impact HCT for YSHCN. A draft needs assessment for all types of providers caring for YSHCN is provided and more specific work in the three areas combined is recommended.