Transitions for youth and young adults with eating disorders and/or other mental health conditions: a Canadian guideline.

IF 4.5 3区 医学 Q2 NUTRITION & DIETETICS
Gina Dimitropoulos, Maria Nicula, Andrea Krishnapillai, Amelia Austin, Manya Singh, Jayden Lee, Cheryl Webb, Sela Scott, Ana Cláudia Vieira de Almeida, Clara Bergmann, Heidi Vander Steen, Melissa Kimber, Christopher Mushquash, Lia Norman, Jessica Sauerwein, Aaron Keshen, Ahmed Boachie, Alène Toulany, Andrea Levinson, Anita Federici, Brooke Allemang, Catherine Ford, Debra K Katzman, Emily Tam, Gail McVey, Howard Steiger, Jennifer Scarborough, Jennifer S Coelho, Jennifer Thannhauser, Josie Geller, Karleigh Darnay, Jo Henderson, Katherine Bright, Katie Soper, Leanna Isserlin, Linda Booij, Melissa Brouwers, Michele Laliberté, Monique Jericho, Nicole Obeid, Sarah Smith, Seena Grewal, Shauna MacEachern, Sheri Findlay, Wendy Preskow, Wendy Spettigue, Aryel Maharaj, Lori Wozney, Srividya Iyer, Mark Norris, Helen Vallianatos, Shaleen Jones, Emilie Lacroix, Manuela Ferrari, Cathleen Steinegger, Techiya Loewen, Joanne Gusella, Anick LeClerc, Natasha Johnson, Suzanne Phillips, Megan Patton, Zoya Punjwani, Katelyn Greer, Neera Bhatnagar, Jennifer Couturier
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引用次数: 0

Abstract

Background: Eating disorders (EDs) are severe mental illnesses with high rates of mortality, morbidity, and reduced quality of life. Their onset occurs during adolescence and early adulthood, coinciding with the critical transition from pediatric to adult care. To address the lack of guidelines to support ED transitions in Canada, this study developed evidence-based guideline recommendations.

Methods: Scoping review methodology was employed using comprehensive searches across seven databases, supplemented by forward and backward citation chaining to identify records on youth and young adults (YYAs) (16-25 years) with EDs and/or mental health conditions transitioning from pediatric to adult care. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to evaluate the quality of the evidence for applicable studies. Using a modified Delphi method, the evidence was reviewed by a guideline development panel and consensus was achieved in a single round of voting.

Results: After de-duplication, 14,350 records from all sources were screened, with 1817 studies undergoing full-text review. A total of 419 studies were included. Of these, 199 were primary research studies which fell under one or more of the following categories: descriptive (n = 86), qualitative (n = 75), predictors (n = 48), transition interventions (n = 21), measurement tools (n = 8), and key outcomes (n = 3). The certainty of the evidence for specific interventions and tools was generally low.

Recommendations: The panel issued strong recommendations for integrated, collaborative transition approaches involving YYAs, families, and providers, and for the use of the Transition Readiness Assessment Questionnaire (TRAQ) to support transition planning. Additional recommendations are included, with an emphasis on future research focused on long-term outcomes such as care continuity and treatment retention.

Conclusion: This research addressed the absence of a cohesive approach to transitions for YYAs experiencing EDs and/or mental health conditions, highlighting evidence variability and the need for a unified approach. These guidelines propose actionable steps for improving care transitions for YYAs with EDs and/or mental health conditions by promoting collaborative care models, prioritizing outcome-focused research, and using measurement tools.

Abstract Image

患有饮食失调和/或其他精神健康状况的青少年和年轻人的过渡:加拿大指南
背景:进食障碍(EDs)是一种严重的精神疾病,具有高死亡率、高发病率和高生活质量。它们发生在青春期和成年早期,与从儿科到成人护理的关键过渡相吻合。为了解决加拿大缺乏支持ED转变的指南的问题,本研究制定了基于证据的指南建议。方法:采用范围审查方法,对7个数据库进行综合检索,并辅以正向和反向引文链,以确定16-25岁的青少年和年轻成人(YYAs)急诊科和/或精神健康状况从儿科过渡到成人护理的记录。建议分级评估、发展和评价方法用于评价适用研究证据的质量。采用改进的德尔菲法,由指南制定小组对证据进行审查,并在单轮投票中达成共识。结果:在重复删除后,从所有来源筛选了14,350条记录,其中1817项研究进行了全文审查。共纳入419项研究。其中,199项是主要研究,属于以下一个或多个类别:描述性(n = 86)、定性(n = 75)、预测因子(n = 48)、过渡干预(n = 21)、测量工具(n = 8)和关键结果(n = 3)。具体干预措施和工具的证据的确定性普遍较低。建议:专家组发布了包括YYAs、家庭和提供者在内的集成的、协作的过渡方法,以及使用过渡准备评估问卷(TRAQ)来支持过渡计划的强烈建议。还包括其他建议,重点是未来的研究侧重于长期结果,如护理连续性和治疗保留。结论:本研究解决了缺乏一种连贯的方法来治疗经历ed和/或精神健康状况的yas的转变,突出了证据的可变性和统一方法的必要性。这些指南提出了可操作的步骤,通过促进协作护理模式,优先考虑以结果为重点的研究,并使用测量工具,改善患有急诊科和/或精神健康状况的青少年的护理过渡。
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来源期刊
Journal of Eating Disorders
Journal of Eating Disorders Neuroscience-Behavioral Neuroscience
CiteScore
5.30
自引率
17.10%
发文量
161
审稿时长
16 weeks
期刊介绍: Journal of Eating Disorders is the first open access, peer-reviewed journal publishing leading research in the science and clinical practice of eating disorders. It disseminates research that provides answers to the important issues and key challenges in the field of eating disorders and to facilitate translation of evidence into practice. The journal publishes research on all aspects of eating disorders namely their epidemiology, nature, determinants, neurobiology, prevention, treatment and outcomes. The scope includes, but is not limited to anorexia nervosa, bulimia nervosa, binge eating disorder and other eating disorders. Related areas such as important co-morbidities, obesity, body image, appetite, food and eating are also included. Articles about research methodology and assessment are welcomed where they advance the field of eating disorders.
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