From pediatrics to adult care - Experiences of transition among youth with a chronic medical condition: A meta-ethnography.

Background: Approximately 10-30 % of the youth (aged 15-24) have a diagnosed chronic medical condition. Effective transition from pediatric to adult care is thus essential for disease management. The growing interest in the transition of young people with chronic medical conditions has led to numerous international studies revealing diverse and often inadequate transition practices. Thus, the aim was to gain a new understanding and deeper insight into youths´ experiences of their transition from paediatric to adult care. Methods: Utilizing the meta-ethnographic method by Noblit and Hare, a structured literature searchwas conducted in CINAHL and PubMed. Results: Ten articles were included. The meta-ethnography found that youth - despite their chronic medical condition - define themselves as primarily young and secondarily chronically ill. Furthermore, youth transitioning to adult care are being the Captain of Their Own Life and hence stand alone with the responsibility of managing their illness, lacking the competence to master it fully, and facing an unorganized healthcare system that does not adequately support their needs. Thus, youth find they are Navigating in the Dark. Conclusion: Adopting a rigorously systematic approach to conducting a meta-ethnography provides new and valuable knowledge into the transition process from pediatric to adult care. Youth with chronic medical conditions encounter multiple challenges in their transition from pediatric to adult care, which has not systematically been integrated into patient care pathways in clinical practice. This review provides a new understanding of youths' transition experiences, on which further research regarding the organization of effective and evidence-based process can be based.