Advancing transition readiness and health outcomes in adolescents with epilepsy: the role of evidence-based self-management interventions in nursing practice.

Background: Self-management interventions are crucial for adolescents with epilepsy (AWEs) to control seizures during their transition to adulthood. However, many AWEs face challenges in sustaining effective self-management, and evidence-based practices tailored to this population remain underexplored. This study developed and evaluated a self-management intervention plan to enhance transition readiness for AWEs.

Methods: The setting is the neurological center of a Grade-III children's hospital in Southwest China. From March 2023 to February 2024, 92 AWEs and their families participated, along with 31 hospital staff members. A historical comparison design evaluated the intervention's effects on AWEs, while a self-controlled design assessed impacts on healthcare providers and the system environment. The intervention was developed using the Knowledge-To-Action framework and intervention mapping theory, guided by a logical model and a matrix of change goals. Through expert consensus, 53 strategies were formed using evidence-based behavior change methods. Key outcomes included behavior and physical health of AWEs, compliance among healthcare providers, and system-level improvements.

Results: Post-intervention, significant improvements were observed across all assessed areas, including self-management, transition readiness, and electroencephalogram results, except for number of seizures and doctor-patient communication. Compliance with self-management behaviors among AWEs and family caregivers increased by 21.43%, healthcare providers' practice compliance improved by 34.08%, and clinical audit results at the system level rose by 58.83%. Notable system-level changes included improved resource allocation and care standardization.

Conclusions: This intervention is a promising approach to improving health outcomes in AWEs and fostering self-management behaviors among patients and caregivers, while enhancing healthcare providers' practice and service capacity. The framework offers valuable guidance for integrating self-management support into transition ecosystems, with implications for both clinical practice and nursing education.